Predictive value of anti-CarP and anti-PAD3 antibodies alone or in combination with RF and ACPA for the severity of rheumatoid arthritis. (27th January 2021)

• Record Type: Journal Article
• Authors: Lamacchia, Celine; Courvoisier, Delphine S; Jarlborg, Matthias; Bas, Sylvette; Roux-Lombard, Pascale; Möller, Burkhard; Ciurea, Adrian; Finckh, Axel; Bentow, Chelsea; Martinez-Prat, Laura; Mahler, Michael; Gabay, Cem; Nissen, Michael J
• Is Part Of: Rheumatology. Volume 60:Number 10(2021)
• Page Start: 4598
• Page End: 4608
• Publication Date: 2021-01-27
• Subjects: RA -- radiographs -- ACPA -- RF -- anti-PAD3 -- anti-CarP; Rheumatism -- Periodicals; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1093/rheumatology/keab050
• Languages: English
• ISSNs: 1462-0324

Abstract

Abstract: Objectives: The objective of this study was to analyse the predictive value of anti-carbamylated protein (anti-CarP) and anti-peptidyl-arginine deiminase type-3 (anti-PAD3) antibodies, alone or in combination with RF and ACPA, to identify patients at high risk of developing severe RA outcomes. Methods: Patients within the Swiss Clinical Quality Management registry with a biobank sample were tested for RF, ACPA, anti-CarP, and anti-PAD3 antibodies. We examined the association of each autoantibody with DAS28, HAQ and radiographic damage (Ratingen) at baseline and longitudinally. Results: Analyses included 851 established RA patients and 516 disease controls [axial spondyloarthritis (axSpA = 320) and PsA (196)]. Anti-CarP and anti-PAD3 antibodies were, respectively, present in 22.4% and 10.7% of the whole RA population, and in 13.2% and 3.8% of the RF and ACPA double seronegative patients. At baseline, RA patients with anti-PAD3 had higher DAS28 (4.2 vs 3.7; P = 0.005) and significantly more radiographic damage (14.9 vs 8.8; P = 0.02) than anti-PAD3-negative patients. In the ACPA-negative subgroup, baseline Ratingen scores were significantly higher in anti-PAD3-positive patients ( P = 0.01). The combination of anti-PAD3, RF IgM, and ACPA was associated with significantly higher baseline radiographic scores than the double seropositive group ( P = 0.04). The presence of any two of the previous autoantibodies was associated with significantly greater radiographic progression over 10 years than if all were absent ( P = 0.02). There were no differences in RA outcome measures with regards to anti-CarP. Conclusions: Anti-PAD3 antibodies are associated with higher disease activity and joint damage scores in RA patients.