Prediction of radiological outcome in early rheumatoid arthritis in clinical practice: role of antibodies to citrullinated peptides (anti-CCP). Issue 9 (12th August 2004)

• Record Type: Journal Article
• Authors: Forslind, K; Ahlmén, M; Eberhardt, K; Hafström, I; Svensson, B
• Other Names: group-author.
• Is Part Of: Annals of the rheumatic diseases. Volume 63:Issue 9(2004)
• Page Start: 1090
• Page End: 1095
• Publication Date: 2004-08-12
• Subjects: AKA, antikeratin antibody -- AFA, antifilaggrin antibody -- APF, antiperinuclear factor -- BARFOT, better anti-rheumatic farmacotherapy study -- CCP, cyclic citrullinated peptides -- DAS, disease activity score -- DMARD, disease modifying antirheumatic drug -- HAQ, health assessment questionnaire -- ICC, intraclass correlation coefficient -- NPV, negative predictive value -- PPV, positive predictive value -- RF, rheumatoid factor -- VAS, visual analogue scale; rheumatoid arthritis -- cyclic citrullinated peptides -- rheumatoid factor -- Larsen score; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/ard.2003.014233
• Languages: English
• ISSNs: 0003-4967

Abstract

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.