Background Rheumatoid arthritis (RA) is an evolving disease. In order to have a tight control and treat it to target, different markers for the measurement of disease activity have been investigated. A new hope emerged with the appearance of the new diagnostic anti-citrullinated protein antibodies (ACPA), such as anti-CCP and antibodies against mutated citrullinated vimentin (anti-MCV).
Objectives The aim of this study was to evaluate the association of ACPA and RF with the parameters of the disease activity and composite disease activity indices.
Methods We performed a cross-sectional study with 220 participants: 95 RA patients, 95 Non-RA patients with systemic inflammatory diseases and 55 healthy controls (HC). Demographic data, laboratory data and physical examination were performed and radiographies taken. ACPA antibody were measured with ELISA method and RF was measured with conventional Latex test.
Results The mean age of the patients was 50, mean disease duration 4,8 years and average disease activity DAS 28 4,83. The sensitivity and specificity of the Anti-MCV, anti-CCP and RF regarding Non-RA patients were as follows: sensitivity 0.72, 0.71 and 0.69 and specificity 0.82, 0.88 and 0.86, respectfully with the area under the curve 0.77, 0,80 and 0,77. Anti-MCV and Anti-CCP antibody positivity was associated with 8 parameters of the disease activity. The common parameters for all the 3 antibodies were ESR, CRP, DAS28 and SDAI. Anti-MCV positivity was associated with Anti-CCP (p<0,001) but not with RF positivity, with higher platelet number, morning stiffness and swollen joint count with p<0,05. Anti-CCP positivity was associated with anti-MCV and RF positivity and titer (p<0,001) and it was exclusively associated with the higher Sharp van der Heijde radiography scores. RF positivity was associated with anti-CCP and anti-MCV positivity and titer, (p<0,05 and 0,04), patient assessment of pain, SJC, TJC, DAS28, CDAI, SDAI and HAQ DI (p<0,05).
Conclusions ACPA antibodies should be further evaluated in association with parameters of RA disease activity but RF should not be neglected as well.
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Acknowledgement This study was supported by ILAR as a part of the ILAR 2009 project in FYR Macedonia.
Disclosure of Interest None declared