Substitution of the quantitative serological component in the 2010 criteria for RA with qualitative presence of three autoantibodies yields similar performance: response to the article by Regueiro et al.

Dijk, Bastiaan T van; Trouw, Leendert A.; Mil, Annette H M van der Helm-van; Huizinga, Tom W J

doi:10.1186/s13075-020-02182-3

Cited by 4 publications

(10 citation statements)

References 4 publications

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“…This characteristic was exploited by us to replace the serological component of the ACR/EULAR 2010 classification criteria by a score based on the concordance of the anti-CarP, RF and anti-CCP autoantibodies. This score led to classify the patients with similar accuracy in our cohort 14 , and, independently in another large cohort of patients with EA 15 . A replication that highlights the advantage of a scoring system that does not require antibody concentrations, its reproducibility.…”

Section: Introductionsupporting

confidence: 65%

“…Independently of its causes, the concordance of antibodies is a defining characteristic of RA patients 16 – 18 , 24 , 27 – 30 , which could be exploited to improve RA classification in another way 14 , 15 . The improvement exploits the better specificity of the concordant presence of two or three antibodies relative to any of them in isolation.…”

Section: Discussionmentioning

confidence: 99%

“…Two areas have been identified that could lead to improvements by incorporating new RA autoantibodies 5 – 7 , 13 – 15 . The most evident would be if the new antibody could cover the need of a biomarker for the 15–45% RA patients that lack RF and anti-CCP antibodies 7 , 13 .…”

Section: Introductionmentioning

confidence: 99%

“…The need for the highest specificity is taken very seriously because classification criteria are developed to obtain homogeneous groups of patients for research 3 , 5 . A way to obtain increased specificity has become possible very recently 14 , 15 . It exploits the concordance of autoantibodies to achieve high specificity, accuracy and reproducibility of the criteria.…”

Section: Introductionmentioning

confidence: 99%

“…Two areas have been identified that could lead to improvements by incorporating new RA autoantibodies [5][6][7][13][14][15] . The most evident would be if the new antibody could cover the need of a biomarker for OPEN 1 Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria -Hospital Clínico Universitario de Santiago (IDIS), Travesia Choupana, sn., 15706 Santiago de Compostela, Spain.…”

mentioning

confidence: 99%

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Improved classification of rheumatoid arthritis with a score including anti-acetylated ornithine antibodies

Rodríguez-Martínez

Bang²,

Regueiro

et al. 2020

Sci Rep

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The presence of rheumatoid factor (RF) or anti-cyclic citrullinated peptide (anti-CCP) autoantibodies contributes to the current rheumatoid arthritis (RA) classification criteria. These criteria involve stratification on antibody levels, which limits reproducibility, and underperform in the RA patients without RF and anti-CCP. Here, we have explored if two anti-acetylated peptide antibodies (AAPA), anti-acetylated lysine (AcLys) and anti-acetylated ornithine (AcOrn), could improve the performance of the current criteria. The analysis was done in 1062 prospectively-followed early arthritis (EA) patients. The anti-AcOrn were more informative than the anti-AcLys, the conventional RA antibodies and the anti-carbamylated protein antibodies. The anti-AcOrn produced a classification that did not require antibody levels and showed improved specificity (77.6% vs. 72.6%, p = 0.003) and accuracy (79.0% vs. 75.8%, p = 0.002) over the current criteria. These improvements were obtained with a scoring system that values concordance between anti-AcOrn, RF and anti-CCP. No significant gain was obtained in sensitivity (80.2% vs. 78.8%, p = 0.25) or in improving the classification of the RA patients lacking RF and anti-CCP, although the anti-AcOrn ranked first among the analysed new antibodies. Therefore, the anti-AcOrn antibodies could contribute to the improvement of RA classification criteria by exploiting antibody concordance.

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Section: Introductionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Improved classification of rheumatoid arthritis with a score including anti-acetylated ornithine antibodies

Rodríguez-Martínez

Bang²,

Regueiro

et al. 2020

Sci Rep

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Increased disease activity in early arthritis patients with anti-carbamylated protein antibodies

Regueiro

Nuño

Triguero-Martínez

et al. 2021

Sci Rep

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The initial management of rheumatoid arthritis (RA) has a high impact on disease prognosis. Therefore, we need to select the most appropriate treatment as soon as possible. This goal requires biomarkers of disease severity and prognosis. One such biomarker may be the presence of anti-carbamylated protein antibodies (ACarPA) because it is associated with adverse long term outcomes as radiographic damage and mortality. Here, we have assessed the ACarPA as short-term prognostic biomarkers. The study was conducted in 978 prospective early arthritis (EA) patients that were followed for two years. Our results show the association of ACarPA with increased levels of all the disease activity measures in the first visit after arthritis onset. However, the associations were more significant with the high levels in local measures of inflammation and physician assessment than with the increases in systemic inflammation and patient-reported outcomes. More notably, disease activity was persistently increased in the ACarPA positive patients during the two years of follow-up. These differences were significant even after accounting for the presence of other RA autoantibodies. Therefore, the ACarPA could be considered short-term prognostic biomarkers of increased disease activity in the EA patients.

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From Rheumatoid Factor to Anti-Citrullinated Protein Antibodies and Anti-Carbamylated Protein Antibodies for Diagnosis and Prognosis Prediction in Patients with Rheumatoid Arthritis

Yang

Luo

et al. 2021

IJMS

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Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease mainly involving synovial inflammation and articular bone destruction. RA is a heterogeneous disease with diverse clinical presentations, prognoses and therapeutic responses. Following the first discovery of rheumatoid factors (RFs) 80 years ago, the identification of both anti-citrullinated protein antibodies (ACPAs) and anti-carbamylated protein antibodies (anti-CarP Abs) has greatly facilitated approaches toward RA, especially in the fields of early diagnosis and prognosis prediction of the disease. Although these antibodies share many common features and can function synergistically to promote disease progression, they differ mechanistically and have unique clinical relevance. Specifically, these three RA associating auto-antibodies (autoAbs) all precede the development of RA by years. However, while the current evidence suggests a synergic effect of RF and ACPA in predicting the development of RA and an erosive phenotype, controversies exist regarding the additive value of anti-CarP Abs. In the present review, we critically summarize the characteristics of these autoantibodies and focus on their distinct clinical applications in the early identification, clinical manifestations and prognosis prediction of RA. With the advancement of treatment options in the era of biologics, we also discuss the relevance of these autoantibodies in association with RA patient response to therapy.

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Substitution of the quantitative serological component in the 2010 criteria for RA with qualitative presence of three autoantibodies yields similar performance: response to the article by Regueiro et al.

Cited by 4 publications

References 4 publications

Improved classification of rheumatoid arthritis with a score including anti-acetylated ornithine antibodies

Improved classification of rheumatoid arthritis with a score including anti-acetylated ornithine antibodies

Increased disease activity in early arthritis patients with anti-carbamylated protein antibodies

From Rheumatoid Factor to Anti-Citrullinated Protein Antibodies and Anti-Carbamylated Protein Antibodies for Diagnosis and Prognosis Prediction in Patients with Rheumatoid Arthritis

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