Background Little is known regarding the prevalence of erosive disease in a contemporary cohort of patients with RA and whether erosive disease prevalence differs by disease duration and seropositivity to anti-citrullinated protein antibodies (ACPA).
Objectives To characterize the proportion of patients with RA with erosive disease by disease duration category and stratified by positive and negative serological status (anti-cyclic citrullinated peptide [anti-CCP], a surrogate for ACPA).
Methods We identified patients with RA aged ≥18 years who were enrolled in the Corrona registry (October 2001–June 2016), with available disease duration, radiographic/MRI/ultrasound studies and serological status based on anti-CCP. Patients were grouped based on RA disease duration (0–2, 3–5, 6–10 and >10 years from diagnosis). Unadjusted prevalence erosion rates were calculated based on the proportion of patients with reports of erosions present on joint radiographs/MRIs/ultrasounds. Seropositivity was based on laboratory results (anti-CCP ≥20 U/mL) at enrolment in the Corrona registry. Chi-squared tests were used to assess differences in prevalence rates.
Results There were 9759 patients who met inclusion criteria. Most were women (76%), middle-aged (mean [SD] 57 years ), with moderate disease activity (mean [SD] CDAI 14.7 [13.4]). Prior use of at least one biologic or targeted synthetic DMARD had occurred in 41% of patients. Overall, the prevalence of erosive disease was 28.6%, with higher prevalence among CCP+ (35.4%) vs CCP– (20.1%) patients (p<0.001, chi-squared test). The prevalence of erosions increased with increasing disease duration (p<0.001; Table). For each disease duration group, the prevalence of erosions was higher in patients who were CCP+ compared with those who were CCP−.
Conclusions Erosions were common in this cohort of patients, and prevalence of erosions increased with longer disease duration. Patients who were CCP+ had higher rates of prevalent erosions than those who were CCP– with similar disease duration.
Disclosure of Interest L. Harrold Shareholder of: Corrona LLC, Grant/research support from: Pfizer, AstraZeneca, Consultant for: Roche, Med IQ, K. Price Employee of: Bristol-Myers Squibb, H. Litman Employee of: Corrona LLC, S. Connolly Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, E. Alemao Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, S. Rebello Employee of: Corrona LLC, W. Hua Employee of: Corrona LLC, J. Kremer Shareholder of: Corrona LLC, Grant/research support from: AbbVie, Bristol-Myers Squibb, Genentech, Lilly, Novartis, Pfizer, Employee of: Corrona LLC, Speakers bureau: Genentech