Arthritis development in patients with arthralgia is strongly associated with anti-citrullinated protein antibody status: a prospective cohort study

Abstract

Arthritis development in patients with arthralgia is strongly associated with anti-citrullinated protein antibody status: a prospective cohort study Bos, W.H.; Wolbink, G.J.; Boers, M.; Tijhuis, G.J.; de Vries, N.; van der Horst-Bruinsma, I.E.; Tak, P.P.; van de Stadt, R.J.; van der Laken, C.J.; Dijkmans, B.A.C.; van Schaardenburg, D. General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Arthritis development in patients with arthralgia is strongly associated with anti-citrullinated protein antibody status: a prospective cohort study

Synovial tissue research: a state-of-the-art review

“…82 Up to 30% of RA patients never develop ACPA. 85 An association has been defined between the presence of circulating ACPA and subsequent development of RA in subjects with arthralgia, 87 and with bone erosions in early untreated subjects. 88 Delay in diagnosis of RA may arise from either a lack of a definitive biomarker, or a failure to meet current diagnostic criteria, and these criteria have a significant reliance on biomarkers.…”

Macrophage positron emission tomography imaging as a biomarker for preclinical rheumatoid arthritis: Findings of a prospective pilot study

“…There is evidence that RA is preceded by a preclinical phase that is characterized by the development of autoantibodies, such as rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPAs) (2)(3)(4). The presence of arthralgia may even further increase the risk of developing arthritis in ACPA-positive individuals (4).…”

Review: Preclinical Rheumatoid Arthritis: Progress Toward Prevention

“…However, in those with genetic risk factors, the additional presence of RA-related autoantibodies appears to add significant predictive power; in a recent prospective study of healthy relatives of RA patients, anti-CCP positivity was associated with a 5-year PPV of 61%, compared to 0.4% in anti-CCPnegative subjects (47). Likewise, seropositive individuals with joint symptoms appear to have a markedly higher risk of arthritis development (48)(49)(50), with absolute risks of up to 50% at 12 months. These studies are not directly comparable, but the striking gains in predictive ability highlight the value of combining autoantibodies with other variables in order to achieve clinically useful risk stratification.…”

“…Evidence from Dutch and UK cohorts indicates that symptoms add significant predictive power in seropositive individuals (48)(49)(50). Bos et al found that 20% of their cohort of ACPA and/ or RF-positive patients with arthralgia of any form experienced progression to arthritis after a median follow-up of 28 months (48). Interestingly, of the subgroup with symmetric small joint pain and morning stiffness, 60% progressed to arthritis development, although the absolute numbers of patients were small.…”

“…It is therefore useful to know if a particular symptom complex can identify those at higher risk of progression to arthritis, over and above laboratory biomarkers such as serology. Evidence from Dutch and UK cohorts indicates that symptoms add significant predictive power in seropositive individuals (48)(49)(50). Bos et al found that 20% of their cohort of ACPA and/ or RF-positive patients with arthralgia of any form experienced progression to arthritis after a median follow-up of 28 months (48).…”