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Logo of annrheumdAnnals of the Rheumatic DiseasesCurrent TOCInstructions for authors
Ann Rheum Dis. Sep 2004; 63(9): 1090–1095.
PMCID: PMC1755129

Prediction of radiological outcome in early rheumatoid arthritis in clinical practice: role of antibodies to citrullinated peptides (anti-CCP)

Abstract

Objective: To investigate the role of anti-cyclic citrullinated peptide antibody (anti-CCP) for the prediction of radiological outcome in patients with early rheumatoid arthritis.

Methods: Anti-CCP was assessed at baseline in 379 patients with early rheumatoid arthritis (disease duration <1 year). Radiological joint damage and progression were assessed by Larsen score after two years of follow up (end point) and used as outcome variables. The prognostic value of anti-CCP and other demographic and disease related baseline variables were assessed by univariate and multivariate analyses, including calculation of odds ratios (OR), predictive values, and multiple logistic regression models.

Results: The presence of anti-CCP was associated with significantly higher Larsen score both at baseline and at end point. Univariate predictor analysis showed that anti-CCP had the highest significant OR for radiological joint damage and progression after baseline Larsen score, followed by rheumatoid factor, erythrocyte sedimentation rate (ESR), C reactive protein, age, smoking status, and sex. In stepwise multiple regression analyses, baseline Larsen score, anti-CCP, and ESR were selected as significant independent predictors of the radiological outcomes.

Conclusions: There is good evidence for an association of anti-CCP with radiological joint changes in rheumatoid arthritis. Anti-CCP is an independent predictor of radiological damage and progression. Though prediction in early rheumatoid arthritis is still far from perfect, the use of anti-CCP in clinical practice should make it easier for rheumatologists to reach judicious treatment decisions.

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Selected References

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  • Harrison B, Symmons D. Early inflammatory polyarthritis: results from the Norfolk Arthritis Register with a review of the literature. II. Outcome at three years. Rheumatology (Oxford) 2000 Sep;39(9):939–949. [PubMed]
  • Scott DL. Prognostic factors in early rheumatoid arthritis. Rheumatology (Oxford) 2000 Jun;39 (Suppl 1):24–29. [PubMed]
  • Vincent Christian, Nogueira Leonor, Sebbag Mireille, Chapuy-Regaud Sabine, Arnaud Michel, Letourneur Odile, Rolland Dominique, Fournié Bernard, Cantagrel Alain, Jolivet Michel, et al. Detection of antibodies to deiminated recombinant rat filaggrin by enzyme-linked immunosorbent assay: a highly effective test for the diagnosis of rheumatoid arthritis. Arthritis Rheum. 2002 Aug;46(8):2051–2058. [PubMed]
  • Mediwake R, Isenberg DA, Schellekens GA, van Venrooij WJ. Use of anti-citrullinated peptide and anti-RA33 antibodies in distinguishing erosive arthritis in patients with systemic lupus erythematosus and rheumatoid arthritis. Ann Rheum Dis. 2001 Jan;60(1):67–68. [PMC free article] [PubMed]
  • Schellekens GA, de Jong BA, van den Hoogen FH, van de Putte LB, van Venrooij WJ. Citrulline is an essential constituent of antigenic determinants recognized by rheumatoid arthritis-specific autoantibodies. J Clin Invest. 1998 Jan 1;101(1):273–281. [PMC free article] [PubMed]
  • Schellekens GA, Visser H, de Jong BA, van den Hoogen FH, Hazes JM, Breedveld FC, van Venrooij WJ. The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide. Arthritis Rheum. 2000 Jan;43(1):155–163. [PubMed]
  • Kroot EJ, de Jong BA, van Leeuwen MA, Swinkels H, van den Hoogen FH, van't Hof M, van de Putte LB, van Rijswijk MH, van Venrooij WJ, van Riel PL. The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis. Arthritis Rheum. 2000 Aug;43(8):1831–1835. [PubMed]
  • Visser Henk, le Cessie Saskia, Vos Koen, Breedveld Ferdinand C, Hazes Johanna M W. How to diagnose rheumatoid arthritis early: a prediction model for persistent (erosive) arthritis. Arthritis Rheum. 2002 Feb;46(2):357–365. [PubMed]
  • Svensson B, Schaufelberger C, Teleman A, Theander J. Remission and response to early treatment of RA assessed by the Disease Activity Score. BARFOT study group. Better Anti-rheumatic Farmacotherapy. Rheumatology (Oxford) 2000 Sep;39(9):1031–1036. [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]
  • Zetterquist H, Olerup O. Identification of the HLA-DRB1*04, -DRB1*07, and -DRB1*09 alleles by PCR amplification with sequence-specific primers (PCR-SSP) in 2 hours. Hum Immunol. 1992 May;34(1):64–74. [PubMed]
  • Ekdahl C, Eberhardt K, Andersson SI, Svensson B. Assessing disability in patients with rheumatoid arthritis. Use of a Swedish version of the Stanford Health Assessment Questionnaire. Scand J Rheumatol. 1988;17(4):263–271. [PubMed]
  • Larsen A, Dale K, Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn (Stockh) 1977 Jul;18(4):481–491. [PubMed]
  • Landewé RBM, Boers M, van der Heijde DMFM. How to interpret radiological progression in randomized clinical trials? Rheumatology (Oxford) 2003 Jan;42(1):2–5. [PubMed]
  • Scott DL, Pugner K, Kaarela K, Doyle DV, Woolf A, Holmes J, Hieke K. The links between joint damage and disability in rheumatoid arthritis. Rheumatology (Oxford) 2000 Feb;39(2):122–132. [PubMed]
  • Forslind K, Vincent C, Serre G, Svensson B. Antifilaggrin autoantibodies in early rheumatoid arthritis. Scand J Rheumatol. 2000;29(5):320–322. [PubMed]
  • Forslind K, Vincent C, Serre G, Svensson B. Antifilaggrin antibodies in early rheumatoid arthritis may predict radiological progression. Scand J Rheumatol. 2001;30(4):221–224. [PubMed]
  • Paimela L, Gripenberg M, Kurki P, Leirisalo-Repo M. Antikeratin antibodies: diagnostic and prognostic markers for early rheumatoid arthritis. Ann Rheum Dis. 1992 Jun;51(6):743–746. [PMC free article] [PubMed]
  • Vasiliauskiene L, Wiik A, Høier-Madsen M. Prevalence and clinical significance of antikeratin antibodies and other serological markers in Lithuanian patients with rheumatoid arthritis. Ann Rheum Dis. 2001 May;60(5):459–466. [PMC free article] [PubMed]
  • Meyer O, Combe B, Elias A, Benali K, Clot J, Sany J, Eliaou JF. Autoantibodies predicting the outcome of rheumatoid arthritis: evaluation in two subsets of patients according to severity of radiographic damage. Ann Rheum Dis. 1997 Nov;56(11):682–685. [PMC free article] [PubMed]
  • Genevay S, Hayem G, Verpillat P, Meyer O. An eight year prospective study of outcome prediction by antiperinuclear factor and antikeratin antibodies at onset of rheumatoid arthritis. Ann Rheum Dis. 2002 Aug;61(8):734–736. [PMC free article] [PubMed]
  • Meyer O, Labarre C, Dougados M, Goupille Ph, Cantagrel A, Dubois A, Nicaise-Roland P, Sibilia J, Combe B. Anticitrullinated protein/peptide antibody assays in early rheumatoid arthritis for predicting five year radiographic damage. Ann Rheum Dis. 2003 Feb;62(2):120–126. [PMC free article] [PubMed]
  • Vencovský J, Machácek S, Sedová L, Kafková J, Gatterová J, Pesáková V, Růzicková S. Autoantibodies can be prognostic markers of an erosive disease in early rheumatoid arthritis. Ann Rheum Dis. 2003 May;62(5):427–430. [PMC free article] [PubMed]
  • van Zeben D, Hazes JM, Zwinderman AH, Vandenbroucke JP, Breedveld FC. Factors predicting outcome of rheumatoid arthritis: results of a followup study. J Rheumatol. 1993 Aug;20(8):1288–1296. [PubMed]
  • van der Heijde DM, van Riel PL, van Leeuwen MA, van 't Hof MA, van Rijswijk MH, van de Putte LB. Prognostic factors for radiographic damage and physical disability in early rheumatoid arthritis. A prospective follow-up study of 147 patients. Br J Rheumatol. 1992 Aug;31(8):519–525. [PubMed]
  • Combe B, Dougados M, Goupille P, Cantagrel A, Eliaou JF, Sibilia J, Meyer O, Sany J, Daurès JP, Dubois A. Prognostic factors for radiographic damage in early rheumatoid arthritis: a multiparameter prospective study. Arthritis Rheum. 2001 Aug;44(8):1736–1743. [PubMed]
  • Rau R, Herborn G, Zueger S, Fenner H. The effect of HLA-DRB1 genes, rheumatoid factor, and treatment on radiographic disease progression in rheumatoid arthritis over 6 years. J Rheumatol. 2000 Nov;27(11):2566–2575. [PubMed]
  • Eberhardt K, Fex E, Johnson U, Wollheim FA. Associations of HLA-DRB and -DQB genes with two and five year outcome in rheumatoid arthritis. Ann Rheum Dis. 1996 Jan;55(1):34–39. [PMC free article] [PubMed]
  • Mattey DL, Hassell AB, Dawes PT, Cheung NT, Poulton KV, Thomson W, Hajeer AH, Ollier WE. Independent association of rheumatoid factor and the HLA-DRB1 shared epitope with radiographic outcome in rheumatoid arthritis. Arthritis Rheum. 2001 Jul;44(7):1529–1533. [PubMed]
  • Harrison Beverley J. Influence of cigarette smoking on disease outcome in rheumatoid arthritis. Curr Opin Rheumatol. 2002 Mar;14(2):93–97. [PubMed]

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