Duration of preclinical rheumatoid arthritis-related autoantibody positivity increases in subjects with older age at time of disease diagnosis

Abstract

Corresponding author: V. Michael Holers, MD, Division of Rheumatology, University of Colorado at Denver and Health Sciences Center, Barbara Davis Center, 1775 North Ursula Street, Aurora, Colorado 80045, Phone: (303) Fax: (303) 724-7581, Michael.Holers@uchsc.edu. Address for reprint requests: Same as above * These two authors contributed equally to the study. COMPETING INTERESTSThe authors declare that they have no competing interests. AUTHORS' CONTRIBUTIONSDM participated in the design and analysis of this study and the writing of this manuscript. KD participated in the analysis of data and preparation of manuscript. LP participated in the analysis of samples and data and preparation of manuscript. AB and AL contributed statistical expertise in the analysis of data for this manuscript. CW participated in subject evaluation and determination of eligibility for this study MR participated in the design of this study and procurement of the serum samples for analysis WG participated in the design of this study and procurement of the serum samples for analysis, as well as subject evaluation and determination of eligibility for this study. JN participated in the design and analysis of this study and preparation of manuscript. VMH participated in the design and analysis of this study, antibody testing, and manuscript preparation. DISCLAIMERThe views expressed in this abstract are those of the authors and do not reflect the official policy of the Department of the Army, Department of Defense, or U.S. Government.The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive license (or non-exclusive for government employees) on a worldwide basis to the BMJ Publishing Group Ltd and its Licensees to permit this article to be published in Annals of Rheumatic Diseases editions and any other BMJPGL products to exploit all subsidiary rights, as set out in our license http://ard.bmjjournals.com/ifora/licence.pdf. Objectives-This study investigated factors that may influence the prevalence and timing of appearance of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies during the pre-clinical phase of rheumatoid arthritis (RA) development. NIH Public AccessMethods-243 serial pre-diagnosis serum samples from 83 subjects with RA were examined for the presence of RF and anti-CCP antibodies.Results-57% and 61% of subjects had at least one pre-diagnosis sample positive for RF or anti-CCP, respectively. Gender and race were not significantly associated with the prevalence or timing of pre-clinical antibody appearance. Pre-clinical anti-CCP positivity was strongly associated with the development of erosive RA (OR 4.64; 95% CI 1.71-12.63; p=0.003), but RF was not (p=0.11). Additionally, as age at the time of diagnosis of RA increased the duration of pre-diagnosis antibody positivity for RF and anti-CCP increased, with the longest duration of preclinical antibody positivity seen in patients diagnosed with RA over the age of 40. In ...

Rheumatoid Arthritis following a Treatment with IFN-alpha/Ribavirin against HCV Infection

“…However, our case did not exhibit any symptoms or signs of RA in the presence of high titers of anti-CCP antibodies. Antibodies to citrullinated pep- tides have been demonstrated to precede the development of RA by several years (12), as observed in the present case. It is suggested that in addition to the synthesis of anti-CCP antibodies, additional events are needed to trigger the clinical onset of RA.…”

Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis

“…The risk of unrecognized disease speaks to the importance of rheumatologic evaluation in patients presenting with NMO/NMOSD in order to adequately rule out coexistent CTD. Similarly, in the 2 patients with NMO alone, the presence of antinuclear and SSA antibodies could represent preclinical autoimmunity prior to the onset of symptomatic disease, as described in other autoimmune conditions such as rheumatoid arthritis (45,46). Continued monitoring of these patients is warranted.…”

Familial clustering of the serum cytokine profile in the relatives of rheumatoid arthritis patients

“…Of these 273 first-degree relatives, 59 (22%) were recruited from 29 families in whom the RA proband was not included in the study for a variety of reasons, including lack of availability, death, etc. The median number of firstdegree relatives per family was 3 (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. The distribution of first-degree relatives relative to family size is available online at www.proteome.ca.…”

“…Moreover, we have shown that approximately one-third of the first-degree relatives of North American Native patients with RA are seropositive for anti-citrullinated protein antibodies (ACPAs) and/or rheumatoid factor (RF) (9). Since it has been shown in several other populations that these two RA-associated autoantibodies are often present in the serum of individuals months to years prior to the onset of clinically detectable RA (10)(11)(12), first-degree relatives from this population appear to be at risk of future development of the disease.…”