Objectives To evaluate the predictive value of autoantibodies (Ab) directed against citrullinated recombinant rat filaggrin (ACRFA) detected by a new ELISA for prognosis in a cohort of community cases of RA.
Methods 127 patients (mean age: 50.5 yr, F/M: 2.9) with early RA (median disease duration: 2 yr) were enrolled prospectively in 1996 (T1), primarily from a population based-recruitment (80%), and were followed until 1999 (T2). At T1 were tested rheumatoid factors determined by the latex fixation test (LFT) and anti-filaggrin Abs identified by different assays, i.e. anti-keratin Ab (AKA), and anti-perinuclear factor (APF) by indirect immunofluorescence, ACRFA by an ELISA test whose results are expressed as the difference of OD values given by sera tested against the citrullinated and non-citrullinated forms of filaggrin. At T1 and T2: radiographs of the hands and wrists. Prognosis was defined by (1) radiological damage (van der Heijde modified Sharp method) at T2; (2) progression of radiological damage between T1 and T2.
Results At T1: RA had mild activity (Ritchie articular index: 11/78, mean CRP: 15 mg/l), mild functional disability (HAQ: 0.8/3), mild X-ray destruction (Sharp: 9.2/280); 96% of patients were treated at T1 (DMARDs: 95%; prednisone: 72%); frequency of LFT, AKA, APF and ACRFA were respectively: 50%, 33%, 45% and 45%. At T2: total Sharp score: 22.8/280. The only parameter at T1 associated with a higher Sharp score at T2 (p = 0.03) and particularly with a more important radiological progression (p = 0.03) was the LFT.
Conclusion Whatever the method used, indirect immunofluorescence or ELISA, anti-filaggrin do not allow to predict radiological damage in community cases of RA of limited duration.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.