Anti‐cyclic citrullinated peptide but not rheumatoid factor is associated with ultrasound‐detected bone erosion among rheumatoid arthritis patients with at least moderate disease activity. (17th August 2020)

• Record Type: Journal Article
• Authors: Tan, York Kiat; Li, HuiHua; Allen, John Carson; Thumboo, Julian
• Is Part Of: International journal of rheumatic diseases. Volume 23:Number 10(2020)
• Page Start: 1337
• Page End: 1343
• Publication Date: 2020-08-17
• Subjects: anti‐CCP -- bone erosion -- rheumatoid arthritis -- rheumatoid factor -- synovitis -- ultrasound; Rheumatology -- Periodicals; Rheumatology -- Asia -- Periodicals; Rheumatology -- Pacific Area -- Periodicals; Rheumatic Diseases -- Periodicals; Connective Tissue Diseases -- Periodicals; Immune System Diseases -- Periodicals; 616.723
• DOI: 10.1111/1756-185X.13933
• Languages: English
• ISSNs: 1756-1841

Abstract

Abstract: Aim: To investigate anti‐cyclic citrullinated peptide (anti‐CCP) and rheumatoid factor (RF) in relation to ultrasound‐detected joint inflammation and bone erosion in patients with rheumatoid arthritis (RA) as previous studies have mainly utilized radiographic damage as imaging outcomes. Method: In this cross‐sectional study, patients were grouped based on their Disease Activity Score at 28 joints (DAS28 < 3.2, DAS28 ≥ 3.2). Ultrasound variables (power Doppler and gray scale joint inflammation graded 0‐3 semi‐quantitatively; bone erosion graded Yes = 1/No = 0 dichotomously) were correlated with antibodies levels using Pearson correlation. Simple linear regression was used to characterize relationships between variables. Receiver operating characteristic (ROC) analysis was performed to determine statistically optimal cut‐off values for identifying patient subgroups with ultrasound erosion scores >25th, >50th and >75th percentiles. Results: One thousand and eighty joints and 1800 joint recesses from 36 peripheral joint sites were scanned in 30 adult RA patients (mean disease duration, 70.3 months; 93.3% female; 93.3% anti‐CCP positive; 93.3% RF positive). In the DAS28 < 3.2 group, no significant correlations were found between antibody levels and ultrasound variables. In the DAS28 ≥ 3.2 group, anti‐CCP levels correlated significantly ( r = 0.46, P = .048) and were predictive ( P = .048) of ultrasound erosion scores. Area under the ROC curve based on cut‐off anti‐CCP level of ≥95.2 to identify patients with ultrasound erosion scores >7 (75th percentile) was 0.72 (sensitivity = 83.3%, specificity = 53.8%). Conclusion: The association of anti‐CCP and RF with joint damage appears to differ in RA. Among patients with at least moderate disease activity (DAS28 ≥ 3.2), anti‐CCP—but not RF—is associated with joint damage, being moderately correlated with ultrasound‐detected bone erosion.