Anti-CCP-positive patients with RA have a higher 10-year probability of fracture evaluated by FRAX®: a registry study of RA with osteoporosis/fracture

Abstract

BackgroundPositive anticyclic citrullinated peptide (anti-CCP+) is associated with bone loss in patients with rheumatoid arthritis (RA). However, whether overall positivity or specific levels of anti-CCP are associated with prevalent fracture or a 10-year probability of fracture remains unclear.MethodsThis interim analysis of an RA registry was conducted at Chang Gung Memorial Hospital in Kaohsiung (CGMHK) for RA-related osteoporosis/fracture. Consecutive patients with RA who had visited the rheumatology clinic at CGMHK since September 1, 2014, and fulfilled the classification criteria of RA were enrolled. The demographics, disease duration, Disease activity in 28 joints based on erythrocyte sedimentation rate (DAS28-ESR), lifestyle, evidence of previous fracture, risk factors of fracture in the Fracture Risk Assessment Tool (FRAX®), and FRAX® score of each participant were collected. Anti-CCP, rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and bone mineral density (BMD) were measured at enrollment. The patients were grouped by positivity or quartiles of anti-CCP level (I–IV).ResultsFive hundred twenty-one patients with RA were enrolled through May 31, 2016. In total, 359 (68.9%) patients were anti-CCP+. Compared with anti-CCP− patients, anti-CCP+ patients had a significantly higher DAS28-ESR (p = 0.0001) and 10-year probability of major (15.0 [18.9] vs. 12.0 [15.3], p = 0.0461) or hip (5.0 [9.2] vs. 3.6 [8.2], p = 0.0118) fracture, but a significantly lower BMD of the FN (p = 0.0196). The rates of osteoporosis and previous fracture were comparable. There were 130, 127, 132, and 132 patients in groups I–IV, respectively. The DAS28-ESR was significantly different (p = 0.0001) among the groups and correlated to anti-CCP levels. The BMD and 10-year probability of major (p = 0.0067) and hip (p = 0.0013) fracture among the groups were also different.ConclusionsAnti-CCP+ RA patients had a higher 10-year probability of major or hip fracture, independent of anti-CCP levels, and a lower BMD of the FN than anti-CCP− patients.

Serum sclerostin in rheumatoid-induced osteoporosis

“…Prevalence of osteoporosis in RA patients varied greatly among studies. The previously reported prevalence of osteoporosis in RA patients was 22.0% [23], 25.0% [24], 30.0% [25,26], 32.4% [27], 40.4% [28] while in one study it was as high as 79.8% [29]. In patients with recent-onset RA (< 6 months duration), osteoporosis was found in 25.0% of the patients [30].…”

Is there an association between Anti-Citrullinated Peptide Antibodies and the Severity of Rheumatoid Arthritis Parameters in Algerian Patients?

“…Positive anti-CCP status is primarily associated with bone loss, disability, disease duration and disease activity in RA patients 17 . Our cross study showed this relationship between clinical characteristics, disease activity, joints damages and Anti-CCP status in Algerian RA patient from western Algeria (Sidi Bel Abbes region in particular ).…”

RNA sequencing analysis reveals differential gene expression of CXCL2 in ACPA-positive and ACPA-negative rheumatoid arthritis

“…Moreover, ACPAs are associated with RA severity. RA patients with ACPAs exhibit more severe radiographic damage than those without ACPAs (7)(8)(9)(10). Many studies have suggested that ACPAs play a pathophysiologic role in RA (11).…”