To evaluate
antibodies against cyclic citrullinated
peptides (
anti-CCP) together with
rheumatoid factor (RF),
antinuclear antibodies (ANA) and
C-reactive protein (CRP), in patients affected by
rheumatoid arthritis (RA), before and after
infliximab treatment. Twenty-seven patients (five men and 22 women, mean age of 51.9 years, mean duration of disease 12.6 years) affected by RA, refractory to conventional DMARDs, were treated with
infliximab, at the conventional dosage. Before starting
infliximab and after 22 weeks, on the occasion of the fifth infusion,
anti-CCP antibodies were tested by ELISA method. At the same time
IgM RF, ANA and CRP level were measured. Before
infliximab therapy,
anti-CCP antibodies resulted positive in 23 patients (85.1%); the serum level did not change after
infliximab treatment; only one case negative at baseline became slightly positive
after treatment. Before and after
therapy RF resulted positive in 22 cases (81.4%) and 21 cases (77.7%) respectively; comparing values at baseline with those after 22 weeks of treatment with
infliximab, RF levels significantly decreased, as well as CRP values. In contrast to both
anti-CCP antibodies, which remained stable, and to RF, which fell after
infliximab, ANA were positive > or = 1: 160 in four cases at baseline and in 12
after treatment. The titre of
anti-CCP antibodies did not significantly change after anti-
TNFalpha blocker administration; instead the positivity of RF significantly decreased. As opposed to antinuclear and
anti-dsDNA antibodies, which may appear or increase in titre during
infliximab treatment, the typical
autoantibodies detectable in RA show a different trend; in fact,
anti-CCP antibodies remained stable and RF decreased.