Serial determination of cyclic citrullinated peptide autoantibodies predicted five-year radiological outcomes in a prospective cohort of patients with early rheumatoid arthritis.
Serial determination of cyclic citrullinated peptide autoantibodies predicted five-year radiological outcomes in a prospective cohort of patients with early rheumatoid arthritis.
复制标题
循环柠檬硫化肽自身抗体的序列测定预测了前瞻性类风湿关节炎患者的五年放射学结果。
DOI：
10.1186/ar1896
复制
发表时间：
2006
影响因子：
4.9
通讯作者：
Combe, Bernard
中科院分区：
文献类型：
--
作者：
Meyer, Olivier;Nicaise-Roland, Pascale;Santos, Marie Dos;Labarre, Colette;Dougados, Maxime;Goupille, Philippe;Cantagrel, Alain;Sibilia, Jean;Combe, Bernard
本研究的目的是评价连续测定的抗环瓜氨酸肽（CCP）抗体预测早期类风湿性关节炎（RA）患者结构性关节损伤的潜力，并与单一基线测定进行比较。对99例病程少于1年且无疾病缓解抗风湿药物治疗史的RA患者进行了至少5年的前瞻性随访。使用第二代ELISA测量抗CCP 2浓度。根据货车der Heijde的修订，在手和足X线片上确定Sharp评分。55.5%的患者在基线时检测到抗CCP 2抗体，63.6%的患者在前三年的任何时间检测到抗CCP 2抗体。前三年内任何时间抗CCP 2的存在均与基线时的放射学损伤相关（比值比（OR），3.66; 95%置信区间（95% CI）0.99-13.54），夏普总分5年进展（OR，3.17; 95% CI，1.3-7.7）、侵蚀评分（OR，5.3; 95% CI，1.4-19.2）和关节间隙狭窄评分（OR，2.8; 95% CI，1.15-6.8）。基线时抗CCP 2或IgM RF的存在不能预测这些结局。在整个随访期间，抗CCP 2检测阴性的患者的放射学进展低于抗CCP 2浓度升高的患者;与抗CCP 2抗体水平降低的患者没有差异。HLA DRB 1 * 分型显示平均改良Sharp评分的进展与共享表位等位基因的存在无关。总之，在早期RA患者中，前三年随访期间连续测定的抗CCP 2抗体在预测放射学进展方面优于基线测定。
The objective of this study was to evaluate the potential of serially determined anti-cyclic citrullinated peptide (CCP) antibodies for predicting structural joint damage in patients with early rheumatoid arthritis (RA), compared to a single baseline determination. Ninety-nine RA patients with disease durations of less than one year and no history of disease-modifying antirheumatic drug therapy were followed prospectively for at least five years. Anti-CCP2 concentrations were measured using a second-generation ELISA. Sharp scores as modified by van der Heijde were determined on hand and foot radiographs. Anti-CCP2 antibodies were detected in 55.5% of patients at baseline and 63.6% at any time during the first three years. Presence of anti-CCP2 at any time during the first three years was associated with radiographic damage at baseline (odds ratio (OR), 3.66; 95% confidence interval (95% CI) 0.99–13.54) and with five year progression of the total Sharp score (OR, 3.17; 95% CI, 1.3–7.7), erosion score (OR, 5.3; 95% CI, 1.4–19.2) and joint space narrowing score (OR, 2.8; 95% CI, 1.15–6.8). The presence of anti-CCP2 or IgM RF at baseline did not predict these outcomes. Patients with negative anti-CCP2 tests throughout follow-up had less radiographic progression than patients with increasing anti-CCP2 concentrations; they did not differ from patients with decreasing anti-CCP2 antibody levels. HLADRB1* typing showed that progression of the mean modified Sharp score was not correlated with the presence of the shared epitope alleles. In conclusion, serially determined anti-CCP2 antibodies during the first three years of follow-up performs better than baseline determination for predicting radiographic progression in patients with early RA.