Rheumatology International

, Volume 32, Issue 12, pp 3807–3812

The presence of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor on patients with rheumatoid arthritis (RA) does not interfere with the chance of clinical remission in a follow-up of 3 years

  • Licia Maria Henrique da Mota
  • Leopoldo Luiz dos Santos Neto
  • Jozélio Freire de Carvalho
  • Ivânio Alves Pereira
  • Rufus Burlingame
  • Henri A. Ménard
  • Ieda Maria Magalhães Laurindo
Original Article

DOI: 10.1007/s00296-011-2260-9

Cite this article as:
da Mota, L.M.H., dos Santos Neto, L.L., de Carvalho, J.F. et al. Rheumatol Int (2012) 32: 3807. doi:10.1007/s00296-011-2260-9

Abstract

Autoantibodies in early rheumatoid arthritis (RA) have important diagnostic value. The association between the presence of autoantibodies against cyclic citrullinated peptide and the response to treatment is controversial. To prospectively evaluate a cohort of patients with early rheumatoid arthritis (<12 months of symptoms) in order to determine the association between serological markers (rheumatoid factor (RF), anti-citrullinated protein antibodies) such as anti-cyclic citrullinated peptide antibodies (anti-CCP) and citrullinated anti-vimentin (anti-Sa) with the occurrence of clinical remission, forty patients diagnosed with early RA at the time of diagnosis were evaluated and followed for 3 years, in use of standardized therapeutic treatment. Demographic and clinical data were recorded, disease activity score 28 (DAS 28), as well as serology tests (ELISA) for RF (IgM, IgG, and IgA), anti-CCP (CCP2, CCP3, and CCP3.1) and anti-Sa in the initial evaluation and at 3, 6, 12, 18, 24, and 36 months of follow-up. The outcome evaluated was the percentage of patients with clinical remission, which was defined by DAS 28 lower than 2.6. Comparisons were made through the Student t test, mixed-effects regression analysis, and analysis of variance (significance level of 5%). The mean age was 45 years, and a female predominance was observed (90%). At the time of diagnosis, RF was observed in 50% of cases (RF IgA—42%, RF IgG—30%, and RF IgM—50%), anti-CCP in 50% (no difference between CCP2, CCP3, and CCP3.1) and anti-Sa in 10%. After 3 years, no change in the RF prevalence and anti-CCP was observed, but the anti-Sa increased to 17.5% (P = 0.001). The percentage of patients in remission, low, moderate, and intense disease activity, according to the DAS 28, was of 0, 0, 7.5, and 92.5% (initial evaluation) and 22.5, 7.5, 32.5, and 37.5% (after 3 years). There were no associations of the presence of autoantibodies in baseline evaluation and in serial analysis with the percentage of clinical remission during follow-up of 3 years The presence of autoantibodies in early RA has no predictive value for clinical remission in early RA.

Keywords

Early rheumatoid arthritisRheumatoid factorAnti-CCPAnti-SaRemissionDAS 28

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Licia Maria Henrique da Mota
    • 1
  • Leopoldo Luiz dos Santos Neto
    • 1
  • Jozélio Freire de Carvalho
    • 2
  • Ivânio Alves Pereira
    • 3
  • Rufus Burlingame
    • 4
  • Henri A. Ménard
    • 5
  • Ieda Maria Magalhães Laurindo
    • 6
  1. 1.Rheumatology DivisionHospital Universitário de Brasília da Universidade de BrasíliaBrasiliaBrazil
  2. 2.Rheumatology DivisionClinica de Oncologia (CLION)SalvadorBrazil
  3. 3.Rheumatology DivisionUniversidade Federal de Santa CatarinaFlorianopolisBrazil
  4. 4.INOVA Diagnostics, Inc.San DiegoUSA
  5. 5.Division of RheumatologyMcGill UniversityMontrealCanada
  6. 6.Rheumatology DivisionHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão PauloBrazil