Does the Presence of Anti-CCP Autoantibodies and Their Serum Levels Influence the Severity and Activity in Rheumatoid Arthritis Patients?

Abstract

This study aims to investigate the association of the presence and of the titer of autoantibodies against cyclic citrullinated peptides (aCCP), with clinical manifestations and disease activity in a cohort of patients with rheumatoid arthritis (RA). From January 2000 through December 2005, 135 patients were diagnosed with RA at the Rheumatology Unit of our hospital. Demographic, clinical, laboratory, and therapeutic parameters were evaluated in all patients at study entry and at every follow-up visit. Positivity in aCCP and also their levels were determined for all patients. At the end of the study, we reevaluated the above parameters, dividing patients into aCCP positive and aCCP negative. From 135 patients, 53.3% were aCCP positive. The majority of aCCP-positive patients were males (p<0.001), positive to rheumatoid factor (p<0.001) and current smokers (p<0.05). At diagnosis, aCCP-positive patients presented with higher tender joint counts (p<0.001) and swollen joint counts (p<0.001), and exhibited more active disease, expressed by higher disease activity scores for 28 joints (DAS-28) (p<0.001). At the end of the study, aCCP-positive patients also displayed more active disease, with higher DAS-28 (p<0.001), and more severe disease, as this was indicated by the higher radiological Larsen score (p<0.001). The serum levels of aCCP were not found to be associated with disease activity and severity. In early RA, the presence of aCCP is associated with increased disease activity and severity. This was found to be independent of circulating levels of aCCP.

Extra Articular Manifestations in Egyptian Rheumatoid Arthritis Patients

“…Our results revealed that RF tended to be positive in ACPA positive patients. These results were previously reported by Nishimura et al 19 , Papadopoulos et al 20 and Onder et al 21 . The present study showed strong relationship between disease activity and ACPA titer as it showed higher levels in RA patients with severe disease activity & low levels in patients with mild disease activity, this agrees with the results of Papadopoulos et al, (20) & Onder et al 21 , showed that the majority of ACPA + ve patients exhibited more active disease with higher DAS 28 score 22 .…”

Características laboratoriais de um grupo de pacientes com artrite reumatoide inicial

“…Titles of CCP2 on average tended to be lower than the third generation techniques. We observed high values (on average > 500 IU/dL) with the three techniques, higher than those reported in publications by Lee et al 54 and Papadopoulos et al, 55 two of the few studies on absolute titles of anti-CCP and its correlation with disease progression.…”

Romatoid Artritli Hastalarda Serum Anti-Cyclic Citrullinated Peptid Antikor Düzeyleri ve Hastalık Aktivitesi Arasındaki İlişki

“…There is considerable disagreement about the relationship between anti-CCP positivity and DAS-28 scores in RA patients (26)(27)(28)(29). In this study, DAS-28 scores and serum RF positivity were found to be associated with anti-CCP positivity.…”

“…Despite the view of anti-CCP is a reliable diagnostic and prognostic indicator, its relationship with the activity and severity of the disease is unclear (18). Anti-CCP has been reported to be better than RF, to predict the disease activity over 3 years.…”