• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of annrheumdAnnals of the Rheumatic DiseasesView this articleSubmit a manuscriptReceive email alertsContact usBMJ
Ann Rheum Dis. Jul 2002; 61(7): 603–607.
PMCID: PMC1754168

Rheumatoid factor measured by fluoroimmunoassay: a responsive measure of rheumatoid arthritis disease activity that is associated with joint damage

Abstract

Objectives: To determine whether rheumatoid factors (RFs), measured as continuous variables by time resolved fluoroimmunoassay, reflect disease activity in rheumatoid arthritis (RA). Further, to study the association of RFs and other disease activity parameters with radiological joint damage, especially in individual patients.

Methods: In active, early RA, IgM and IgA RFs, as well as erythrocyte sedimentation rate (ESR), C reactive protein (CRP), tender joint score, and swollen joint score were assessed regularly. At the study start and at 56 and 80 weeks, radiographs of hands and feet were assessed by the Sharp score (van der Heijde modification). Associations between RFs and disease activity parameters were studied. In addition, associations between radiographic damage and disease activity parameters (baseline and time integrated) were analysed by non-parametric tests and multiple regression analysis. The relation between time integrated disease activity parameters and radiological damage in individual patients was analysed and visualised.

Results: 155 patients were included. RF levels were strongly associated with the disease activity parameters (especially ESR and CRP) and with each other. All disease activity parameters, at baseline as well as time integrated parameters, were associated with (the progression of) radiographic damage. Moreover, in individual patients, a linear relationship between time integrated disease activity parameters and progression of radiological damage was seen.

Conclusion: RFs, measured as continuous variables, can be considered as disease activity parameters in patients with RA. The level of RF at baseline and the exposure to RF over time is associated with radiological damage. In individual patients, there is a constant relation between disease activity and radiological damage.

Full Text

The Full Text of this article is available as a PDF (131K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Winska Wiloch H, Thompson K, Young A, Corbett M, Shipley M, Hay F. IgA and IgM rheumatoid factors as markers of later erosive changes in rheumatoid arthritis (RA). Scand J Rheumatol Suppl. 1988;75:238–243. [PubMed]
  • Eberhardt KB, Truedsson L, Pettersson H, Svensson B, Stigsson L, Eberhardt JL, Wollheim FA. Disease activity and joint damage progression in early rheumatoid arthritis: relation to IgG, IgA, and IgM rheumatoid factor. Ann Rheum Dis. 1990 Nov;49(11):906–909. [PMC free article] [PubMed]
  • van Leeuwen MA, Westra J, van Riel PL, Limburg PC, van Rijswijk MH. IgM, IgA, and IgG rheumatoid factors in early rheumatoid arthritis predictive of radiological progression? Scand J Rheumatol. 1995;24(3):146–153. [PubMed]
  • van Zeben D, Hazes JM, Zwinderman AH, Cats A, van der Voort EA, Breedveld FC. Clinical significance of rheumatoid factors in early rheumatoid arthritis: results of a follow up study. Ann Rheum Dis. 1992 Sep;51(9):1029–1035. [PMC free article] [PubMed]
  • van Leeuwen MA, van Rijswijk MH, van der Heijde DM, Te Meerman GJ, van Riel PL, Houtman PM, van De Putte LB, Limburg PC. The acute-phase response in relation to radiographic progression in early rheumatoid arthritis: a prospective study during the first three years of the disease. Br J Rheumatol. 1993 Jun;32 (Suppl 3):9–13. [PubMed]
  • van Leeuwen MA, van Rijswijk MH, Sluiter WJ, van Riel PL, Kuper IH, van de Putte LB, Pepys MB, Limburg PC. Individual relationship between progression of radiological damage and the acute phase response in early rheumatoid arthritis. Towards development of a decision support system. J Rheumatol. 1997 Jan;24(1):20–27. [PubMed]
  • van der Sluijs Veer G, Soons JW. A time-resolved fluoroimmuno assay of the IgM-rheumatoid factor. Eur J Clin Chem Clin Biochem. 1992 May;30(5):301–305. [PubMed]
  • Boers M, Verhoeven AC, Markusse HM, van de Laar MA, Westhovens R, van Denderen JC, van Zeben D, Dijkmans BA, Peeters AJ, Jacobs P, et al. Randomised comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone in early rheumatoid arthritis. Lancet. 1997 Aug 2;350(9074):309–318. [PubMed]
  • Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988 Mar;31(3):315–324. [PubMed]
  • van der Heijde DM, van Riel PL, Nuver-Zwart IH, Gribnau FW, vad de Putte LB. Effects of hydroxychloroquine and sulphasalazine on progression of joint damage in rheumatoid arthritis. Lancet. 1989 May 13;1(8646):1036–1038. [PubMed]
  • Päi S, Päi L, Birkenfeldt R. Correlation of serum IgA rheumatoid factor levels with disease severity in rheumatoid arthritis. Scand J Rheumatol. 1998;27(4):252–256. [PubMed]
  • Gioud-Paquet M, Auvinet M, Raffin T, Girard P, Bouvier M, Lejeune E, Monier JC. IgM rheumatoid factor (RF), IgA RF, IgE RF, and IgG RF detected by ELISA in rheumatoid arthritis. Ann Rheum Dis. 1987 Jan;46(1):65–71. [PMC free article] [PubMed]
  • Eggelmeijer F, Otten HG, de Rooy HH, Daha MR, Breedveld FC. Significance of rheumatoid factor isotypes in seronegative rheumatoid arthritis. Rheumatol Int. 1990;10(1):43–46. [PubMed]
  • Tarkowski A, Nilsson LA. Isotype-specific measurement of rheumatoid factor with reference to clinical features of rheumatoid arthritis. J Clin Lab Immunol. 1983 Nov;12(3):129–135. [PubMed]
  • Houssien DA, Jonsson T, Davies E, Scott DL. Clinical significance of IgA rheumatoid factor subclasses in rheumatoid arthritis. J Rheumatol. 1997 Nov;24(11):2119–2122. [PubMed]
  • Houssien DA, Jónsson T, Davies E, Scott DL. Rheumatoid factor isotypes, disease activity and the outcome of rheumatoid arthritis: comparative effects of different antigens. Scand J Rheumatol. 1998;27(1):46–53. [PubMed]
  • Withrington RH, Teitsson I, Valdimarsson H, Seifert MH. Prospective study of early rheumatoid arthritis. II. Association of rheumatoid factor isotypes with fluctuations in disease activity. Ann Rheum Dis. 1984 Oct;43(5):679–685. [PMC free article] [PubMed]

Figures and Tables

Figure 1
Pattern of changes over time of laboratory based disease activity parameters. Aggregated result of all patients receiving combination treatment (sulfasalazine, methotrexate, and prednisolone). IgM and IgA RF, IgM and IgA rheumatoid factor; ESR, erythrocyte ...
Figure 2
Pattern of changes over time of laboratory based disease activity parameters. Aggregated result of all patients receiving sulfasalazine treatment. IgM and IgA RF, IgM and IgA rheumatoid factor; ESR, erythrocyte sedimentation rate; CRP, C reactive protein. ...
Figure 3
Individual relation between exposure to disease activity (time integrated IgM rheumatoid factor (IgM RF)) and radiological damage (Sharp score, modification van der Heijde (SHS)). Every patient has his/her own line, composed of the consecutive six month ...
Figure 4
Relation between exposure to disease activity and radiological damage in the individual patient. The slope of the curve (α ) is individually constant but can vary between patients.

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles
  • Substance
    Substance
    PubChem Substance links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...