Anti-CCP antibody test predicts the disease course during 3 years in early rheumatoid arthritis (the Swedish TIRA project)
Anti-CCP antibody test predicts the disease course during 3 years in early rheumatoid arthritis (the Swedish TIRA project)
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DOI：
10.1136/ard.2003.016808
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发表时间：
2004-09-01
影响因子：
27.4
通讯作者：
Skogh, T
中科院分区：
文献类型：
--
作者：
Kastbom, A;Strandberg, G;Skogh, T
目的：评估诊断时和3年后抗环瓜氨酸肽（CCP）抗体对新近发作类风湿关节炎（RA）的诊断敏感性，并评估抗CCP抗体作为3年内疾病病程的预测因子。方法：242例近期发作的患者（小于或等于1年）RA纳入瑞典多中心研究“TIRA”1996-98后3年内定期随访。通过酶免疫测定法（EIA）分析抗CCP抗体。通过乳胶凝集和两种同种型特异性（IgM和伊加）EIA分析类风湿因子（RF）。通过血浆CRP、ESR、28关节疾病活动性评分和医生对疾病活动性的总体评估来评估疾病活动性。功能能力进行了评估的健康评估Questionnaire.Results：总体而言，抗CCP抗体的诊断灵敏度为64%，阳性试验的比例增加，根据美国流变学学会的分类标准的履行数量。抗CCP抗体结果与RF相关，但作为更具侵袭性的疾病过程的预测因子优于RF。3年后，5/97例患者的抗CCP状态发生变化：2例由阴性变为阳性，3例由阳性变为阴性。结论：抗CCP抗体检测对早期RA的诊断敏感性与RF相似，但对3年以上病程的预测更准确。虽然平均血清水平下降，抗CCP抗体阳性基本上保持不变3年后诊断和抗风湿治疗开始。
Objectives: To evaluate the diagnostic sensitivity of antibodies to cyclic citrullinated peptide (CCP) in recent onset rheumatoid arthritis (RA) at diagnosis and 3 years later, and to evaluate anti-CCP antibody as a predictor of the disease course during 3 years.Methods: 242 patients with recent onset (less than or equal to1 year) RA were followed up regularly during 3 years after inclusion in the Swedish multicentre study "TIRA'' 1996-98. Anti-CCP antibodies were analysed by an enzyme immunoassay (EIA). Rheumatoid factors (RFs) were analysed by latex agglutination and two isotype-specific (IgM and IgA) EIAs. Disease activity was assessed by plasma CRP, ESR, 28 joint disease activity score, and the physician's global assessment of disease activity. Functional ability was evaluated by the Health Assessment Questionnaire.Results: Overall, the diagnostic sensitivity of anti-CCP antibodies was 64% and the proportion of positive tests increased with the number of fulfilled classification criteria according to the American College of Rheumatology. The anti-CCP antibody results correlated with RF, but were better than RF as predictor of a more aggressive disease course. After 3 years 5/97 patients had changed anti-CCP status: 2 from negative to positive and 3 from positive to negative. The mean level of anti-CCP antibodies declined by 131 U/ml during the 3 year follow up (95% CI 34 to 228 U/ml).Conclusion: The anti-CCP antibody assay has a similar diagnostic sensitivity to that of RF in early RA, but is better as a predictor of the disease course over 3 years. Although the mean serum level declines, anti-CCP antibody positivity remains essentially unaltered 3 years after diagnosis and start of antirheumatic treatment.