Abstract | OBJECTIVE: METHODS: 279 patients with early RA were followed up with clinical investigations, radiographs, and measurement of anti-CP at baseline and after 3 months, 1, 2, 3, and 5 years. RESULTS: 160/279 (57.3%) patients were anti-CP positive at the first visit (mean 5 months after first symptoms). During follow up only 11/279 (3.9%) of the patients changed their anti-CP status. Anti-CP levels fell significantly during the first year, and this drop correlated with the extent of sulfasalazine treatment but not with other drugs or clinical indices. Anti-CP positive and negative patients had similar disease activities at baseline, but during follow up the anti-CP positive patients had worse clinical disease and greater radiological progression, despite at least equally intensive antirheumatic treatment. CONCLUSIONS: Anti-CP are stable during the first 5 years of RA, suggesting that events before rather than after onset of clinical manifestations of disease determine this phenotype. The presence of anti-CP at diagnosis predicts a less favourable disease course and greater radiological progression despite antirheumatic treatment, but subsequent changes in antibody levels do not reflect changes in disease activity. Taken together, these observations suggest that anti-CP positive RA is a distinct clinical and pathophysiological entity.
|
Authors | J Rönnelid, M C Wick, J Lampa, S Lindblad, B Nordmark, L Klareskog, R F van Vollenhoven |
Journal | Annals of the rheumatic diseases
(Ann Rheum Dis)
Vol. 64
Issue 12
Pg. 1744-9
(Dec 2005)
ISSN: 0003-4967 [Print] England |
PMID | 15843452
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Antirheumatic Agents
- Autoantibodies
- Biomarkers
- Peptides, Cyclic
- cyclic citrullinated peptide
- C-Reactive Protein
- Rheumatoid Factor
|
Topics |
- Antirheumatic Agents
(therapeutic use)
- Arthritis, Rheumatoid
(diagnostic imaging, drug therapy, immunology)
- Autoantibodies
(blood)
- Biomarkers
(blood)
- C-Reactive Protein
(metabolism)
- Disease Progression
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Peptides, Cyclic
(immunology)
- Prognosis
- Radiography
- Rheumatoid Factor
(blood)
- Severity of Illness Index
|