The relationship between the presence of anti-cyclic citrullinated peptide antibodies and clinical phenotype in very early rheumatoid arthritis
Anti-cyclic citrullinated peptide (anti-CCP) antibodies are highly specific for RA, but are not detectable in all RA patients. The aim of this study was to establish whether the clinical phenotypes of anti-CCP positive and negative disease are distinct at the earliest clinically apparent phase of disease.
Methods: Patients were recruited from the Birmingham early inflammatory arthritis clinic.
Participants were included in the current study if they presented within 3 months of symptom onset and fulfilled 1987 ACR criteria for RA at some point during an 18 month follow-up. Data were collected on demographic variables, joint symptoms and tender (n=68) and swollen (n=66) joint counts.
CRP, ESR, rheumatoid factor and anti-CCP2 status were measured.
Results: 92 patients were included (48 anti-CCP positive). The anti-CCP positive and negative groups were comparable in terms of demographic variables, inflammatory markers, joint counts and 1987 ACR classification criteria, except that more anti-CCP positive patients were rheumatoid factor positive (83.3% vs.
11.4%, p<0.01). There was no significant difference in the pattern of joint involvement, except for an increased prevalence of knee joint swelling in anti-CCP positive patients (42.9% vs.
22.2%, p=0.03).
Conclusions: Patients with and without anti-CCP antibodies present in a similar way, even within three months of clinically apparent disease that eventually develops into RA.
Author: Mohammed CaderAndrew FilerChristopher BuckleyKarim Raza
Credits/Source: BMC Musculoskeletal Disorders 2010, 11:187
Published on: 2010-08-23
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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