Background Rheumatoid Arthritis (RA) is an inflammatory autoimmune disease characterized by joint involvement, pain and inflammation with or without extra-articular joint commitment. Serological markers can guide early diagnosis before that clinical activity takes place, optimizing early diagnosis, less activity and functional disability. RA 33 is considered a diagnosis-marker in RA patients related to prognosis and therapeutic response compared with conventional markers. RA 33 is common in patients with negative conventional markers and with few clinical symptoms.
Objectives Evaluated the frecuency of RA33 in individuals with first-degree relatives of patients with RA and patients diagnosed with early rheumatoid arthritis as a good prognosis marker
Methods A transversal study was conducted evaluated rheumatologic and periodontal condition of 112 individuals with first-degree relatives of patients with RA and 46 patients diagnosed with early rheumatoid arthritis, according to classification criteria for RA (ACR-EULAR 2010). In addition, 47 healthy individuals were included. RA patients and control group were matched for age and gender. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor RF, ACPAs, and RA 33 were performed. VAS Pain Scale, SDAI Index, HAQ and DAS28 were evaluated. Porphyromona gingivalis (Pg) by CRP, IgG1, and IgG2 were determined. The data included in the study were analyzed using STATA 11.1. Associations were determined by the statistical test Chi 2, and Comparisons between groups of rheumatologic diagnosis and median values for continuous variables was performed using Mann-Whitney Test. Approved by the Ethics Committee of the Institution.
Results 112 healthy individuals with first-degree relatives of patients with RA were assessed. Of them 78.3% has periodontal disease, presence of painful joints (30.63%). 36.94% patients had Pg in subgingival plaque samples. In the control group the presence of periodontal disease was 71.74%, tender joints (19.57%), swollen joints (6.52%). Disease activity measures were not representative. Only a woman in the group of family related RA patients was positive for RA 33 (49 years old, without treatment, painful and swollen joints and the presence of periodontal disease and Pg, ESR and CRP positives but RF and ACPAs negative). No patient with RA of less than two years of diagnosis was positive for RA 33.
Conclusions The diagnostic value of anti RA33 was low in this population, with regard of worst prognosis markers and higher disease severity. Ra33 should be more follow-up clinical and paraclinical to subjects with risk factors who could have positive markers, without symptoms.
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Disclosure of Interest None declared