Background In Early Rheumatoid Arthritis, the presence of ACPA positivity is associated with increased disease activity.

Objectives To investigate possible predictors, for high disease activity (DAS-28 >5.1), in a cohort of Greek patients with ACPA positive early RA.

Methods From 2000 until December 2016, 156 patients with ACPA positive early RA, were diagnosed and subsequently followed up as outpatients at the Rheumatology Unit of our hospital. Demographic, clinical, laboratory and therapeutic parameters were evaluated during every follow-up. At the end of the study (last visit during 2016), all the above parameters were re-evaluated, considering the high disase activity (DAS-28 >5.1). The used methods were χ², ANOVA, Binary Logistic Regression (BLR) and ROC Curve.

Results From 156 patients, 25% were males, 37.8% were current smokers, 76.9% were RF positive, 34.6% presenting with extra-articular manifestations and 16% with anemia of chronic disease (ACD). At the time of diagnosis, Univariate analysis revealed that smokers, RF positivity, high levels of CRP, patients with extra-articular manifestations and those with ACD, corellate statstically significant with high disease activity (p=0.011, p=0.006, p=0.03, p=0.001 and p=0.001 respectively). Using the BRL we found that the odds ratio for DAS-28 >5.1, were for smokers 2.95, for RF positivity 3.397 and for CRP 1.066 respectively. Based on the previous results the severity of disease can be predicted with sensitivity 80% (area unedr the curve: p<0.001, CI=0.723–0.878) using the ROC curve.

Conclusions |High Diseasae Activity in ACPA positive early RA, at diagnosis, is best predicted by smoking, RF positivity and high levels of CRP.

References

1. Aletaha D et al, Rheum Dis North Am 2006;32:9–44.

2. ScottDL et al, Lancet 2020;376:1094–1108.

3. Papadopoulos N et al, Clin Rev Allerg Immunol 2008;34:11–15.

References

Disclosure of Interest None declared