PMID- 30717793
OWN - NLM
STAT- In-Data-Review
LR  - 20190210
IS  - 1478-6362 (Electronic)
IS  - 1478-6354 (Linking)
VI  - 21
IP  - 1
DP  - 2019 Feb 4
TI  - Anti-citrullinated protein antibodies are associated with osteopenia but not with
      pain at diagnosis of rheumatoid arthritis: data from the BARFOT cohort.
PG  - 45
LID - 10.1186/s13075-019-1833-y [doi]
AB  - BACKGROUND: Anti-citrullinated protein antibodies (ACPA) have been suggested to
      have a potential role in both bone loss and pain in rheumatoid arthritis (RA),
      based on studies in vitro and in animal models. Here we addressed if anti-cyclic 
      citrullinated (anti-CCP) antibodies were associated with osteopenia or pain in
      patients with RA, at the time for diagnosis. METHODS: Baseline data from the
      BARFOT (Better Anti-Rheumatic PharmacOTherapy) cohort, which consists of patients
      with RA with a disease duration of 1 year or less, were analyzed. To be included,
      they should have been assessed by anti-CCP, dual-energy X-ray absorptiometry
      (DEXA) of lumbar spine and hip, and/or digital X-ray radiogrammetry (DXR) of the 
      metacarpal bones. Osteopenia was defined as a z-score < - 1 SD. Pain VAS > 40 mm,
      was defined as patient unacceptable pain. Multiple logistic regression analyses
      were performed to assess whether anti-CCP was independently associated with
      osteopenia or unacceptable pain. RESULTS: Of the 657 patients, 65% were women,
      58% were anti-CCP positive, 37% had osteopenia in the lumbar spine, and 29% had
      osteopenia in the hip. Sixty-one percent had unacceptable pain at diagnosis.
      Patients positive for anti-CCP had significantly more frequently osteopenia in
      the femoral neck and Ward's triangle compared with anti-CCP-negative patients (p 
      = 0.016 and 0.003, respectively). This difference was found in men at any
      anti-CCP titer, but in women, osteopenia in these hip locations was found only in
      those with high anti-CCP titers (> 500 IU/ml). Anti-CCP was not associated with
      osteopenia in the lumbar spine or the metacarpal bones. In multiple logistic
      regression analyses, anti-CCP was independently associated with osteopenia in the
      femoral neck and/or Ward's triangle but not with unacceptable pain. Instead,
      inflammatory variables were independently associated with unacceptable pain.
      CONCLUSION: These data show that in patients with early RA, anti-CCP positivity
      was independently associated with osteopenia in the femoral neck and/or Ward, but
      not in the lumbar spine. In our patients, we could not confirm a recently
      suggested association between anti-CCP antibodies and pain. Further studies are
      necessary to explore the possible clinical relevance of interactions between
      ACPA, bone, and pain found in vitro and in animal models.
FAU - Hafstrom, Ingiald
AU  - Hafstrom I
AD  - Division of Gastroenterology and Rheumatology, Department of Medicine, Huddinge, 
      Karolinska Institutet, and Rheumatology unit R92, Karolinska University Hospital,
      Stockholm, SE, 141 86, Sweden. ingiald.hafstrom@karolinska.se.
FAU - Ajeganova, Sofia
AU  - Ajeganova S
AD  - Division of Gastroenterology and Rheumatology, Department of Medicine, Karolinska
      Institutet, Huddinge, Sweden.
AD  - Rheumatology Division, Universitair Ziekenhuis Brussel, Vrije Universiteit
      Brussel, Brussels, Belgium.
FAU - Forslind, Kristina
AU  - Forslind K
AD  - Department of Clinical Science, Section of Rheumatology, Faculty of Medicine,
      Lund University, Lund, Sweden.
AD  - Department of Research Education, Skanevard Sund, Region Skane, Helsingborg's
      hospital, Helsingborg, Sweden.
FAU - Svensson, Bjorn
AU  - Svensson B
AD  - Department of Clinical Science, Section of Rheumatology, Faculty of Medicine Lund
      University, Lund, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20190204
PL  - England
TA  - Arthritis Res Ther
JT  - Arthritis research & therapy
JID - 101154438
PMC - PMC6360733
OTO - NOTNLM
OT  - Anti-citrullinated protein antibodies
OT  - Bone mineral density
OT  - Pain
OT  - Rheumatoid arthritis
EDAT- 2019/02/06 06:00
MHDA- 2019/02/06 06:00
CRDT- 2019/02/06 06:00
PHST- 2018/10/18 00:00 [received]
PHST- 2019/01/21 00:00 [accepted]
PHST- 2019/02/06 06:00 [entrez]
PHST- 2019/02/06 06:00 [pubmed]
PHST- 2019/02/06 06:00 [medline]
AID - 10.1186/s13075-019-1833-y [doi]
AID - 10.1186/s13075-019-1833-y [pii]
PST - epublish
SO  - Arthritis Res Ther. 2019 Feb 4;21(1):45. doi: 10.1186/s13075-019-1833-y.