Anti-carbamylated protein antibodies in premenopausal rheumatoid arthritis women: relation to disease activity and bone loss

Abstract

Objectives Anti-carbamylated protein antibodies (anti-CarP Abs) are present in patients with RA, however, their association with bone loss is not confirmed. The purpose of this study was to determine the relation between the serum level of anti-CarP Abs in premenopausal RA women and disease activity and bone loss. Methods This case–control study was conducted on 48 premenopausal women with RA and 48 matched healthy premenopausal women. All RA women were subjected to clinical examination, disease activity assessment using the 28-joint DAS (DAS28) and Clinical Disease Activity Index (CDAI), functional assessment using the HAQ, physical activity assessment using the International Physical Activity Questionnaire (IPAQ), fatigue assessment using the Modified Fatigue Impact Scale (MFIS), serological tests as well as anti-CarP Abs using ELISA. Moreover, the BMD was measured by DXA and plain X-ray of both hands was done to assess juxta-articular osteopenia and erosions. Results The anti-CarP Abs level was significantly higher in RA patients than in healthy controls. The serum level of anti-CarP Abs had a significant positive correlation with the RA DAS28, CDAI, HAQ, MFIS and original Sharp score, while a significant negative correlation was present with the IPAQ. Anti-CarP Abs were negatively correlated with either spine BMD or Z-score and positively correlated with the original Sharp score. Conclusion Anti-CarP Abs were higher in premenopausal RA women compared with older and BMI matched healthy women. Anti-CarP Abs are associated with higher RA disease activity, increased disability and fatigability and decreased physical activity. Moreover, anti-CarP Abs are associated with systemic trabecular bone loss as well as local bone loss.

Analyzing the risk of osteoporosis and fracture in rheumatoid arthritis patients who have been treated with various biologics

“…Although our study has encountered certain limitations, such as incomplete data, 15,16 missing the real osteoporosis dual‐energy X‐ray absorptiometry (DEXA) scan data, detailed fracture data, several other confounding factors like patients' lifestyle, genetic predisposition, 34 other comorbidities 35 of osteoporotic fracture, and the disease activity index of RA, besides, the instances of follow‐up loss within the multifaceted care network of CGMH, and the influence of individual treatment preferences (e.g., a predilection for oral medications over subcutaneous injections, among others), our research effectively mirrors the real‐world implications of RA treatments concerning both osteoporosis and osteoporotic fractures. Besides, severe RA treatments (e.g., biologics) may reflect more severe RA, but because we do not have the severity of RA (e.g., Disease Activity Score‐28 for rheumatoid arthritis [DAS28]) nor the treatment compliance, 36 it is possible that the results of this study will be interfered with by the severity of RA and treatment compliance.…”

Cartilage and bone loss in premenopausal women with rheumatoid arthritis: Radiological and laboratory assessments

“…In addition to all the measurements that were performed in the earlier study, 11 MMP‐3 and COMP were measured at the same time as the previous study by two double sandwich enzyme‐linked immunosorbent assays (ELISA). MMP and COMP antibodies were added to the anti‐l MMP and COMP antibody micro‐ELISA well, incubated and washed.…”

“…This case-control study is a continuation of a study 11 performed on 48 premenopausal women above 16 years of age diagnosed as having RA based on the 2010 American College of Rheumatology/ European League against Rheumatism classification criteria. 11 The exclusion criteria were patients with a history of other autoimmune diseases; other erosive joint diseases, such as erosive OA and gout; systemic diseases that affect bone quality, such as diabetes mellitus and renal diseases; a history or current use of any medications for management of osteoporosis, except for patients treated with calcium and/or vitamin D; smoking; infections and malignancy. Another 48 healthy premenopausal women of matched age and BMI were included as a control group.…”