Background Anti-CCP antibody (ACPA) is widely used for diagnosis of rheumatoid arthritis (RA), and ACPA seropositivity has been known as a factor associated with a poor joint prognosis. However, the importance of ACPA titer, especially its influence for treatment decision, remains unclear.
Objectives The purpose of this study is to analyze whether RA patients with higher ACPA titer need biologics more frequently or not.
Methods We extracted all the RA patients who underwent ACPA test during the period from February 2012 to October 2012. These patients were divided into three groups based on the value of ACPA, e.g. negative (less than 4.5 U/mL), positive (4.5-100 U/mL), and strong positive (more than 100 U/mL). We retrospectively reviewed all the biologic/non-biologic DMARDs the patients had ever used, and compared the rates of biologics use among three groups.
Results The rate of biologic use was significantly lower in negative ACPA group (31.0%) compared to positive ACPA group (55.6%, p<0.05) or strong positive ACPA group (67.9%, p<0.05, Table 1). Among ACPA positive patients, strong ACPA group tend to use biologics more frequently. The rate of patients without biologics nor MTX was significantly higher in negative ACPA group (34.5%) than in ACPA positive group (8.3%, p<0.05) or strong positive ACPA group (5.1%, p<0.05).
Conclusions Not only the ACPA positivity but also high ACPA titer can be predictors for biologics use in RA patients.
Disclosure of Interest None Declared
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