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Rheumatology International

, Volume 35, Issue 10, pp 1693–1699 | Cite as

Associations of rheumatoid factor and anti-citrullinated peptide antibody with disease progression and treatment outcomes in patients with rheumatoid arthritis

  • Wanruchada KatchamartEmail author
  • Ajchara Koolvisoot
  • Emvalee Aromdee
  • Praveena Chiowchanwesawakit
  • Chayawee Muengchan
Original Article - Observational Research

Abstract

The objective of this study was to investigate the association of rheumatoid factor (RF) and anti-citrullinated peptide antibodies (ACPA) status with disease progression and treatment outcomes in patients with rheumatoid arthritis (RA). A total of 276 adult patients who fulfilled the American College of Rheumatology 1987 classification criteria for RA were recruited from the Rheumatology clinic, Siriraj Hospital, from January 2011 to December 2012. Demographic, clinical, and laboratory data were collected at baseline and every 3 months up to 1 year of follow-up. RF and ACPA were measured at baseline. Radiography of the hands and feet was performed at baseline and 1 year. Patients with RF+/ACPA+ had significantly more severe disease activity and impaired functional status than those who had RF−/ACPA−. Although they received more aggressive treatment with methotrexate and combination of non-biologic, disease-modifying antirheumatic drug than other groups, fewer patients in this group achieved remission at 1 year of follow-up, especially when compared to RF−/ACPA− group (12 vs. 18 %). For radiographic erosion, patients with the presence of either RF or ACPA had a higher proportion of hand erosion than seronegative patients at baseline (77, 73, 83, and 32 %, p < 0.001 for RF+/ACPA+, RF+/ACPA−, RF−/ACPA+, and RF−/ACPA−, respectively). After 1 year of follow-up, patients who developed new erosion at the hands were more prevalent in RF+/ACPA+ (32 %) and RF+/ACPA− (33 %) groups. However, “newly developed” feet erosion was most common in RF+/ACPA− group (40 %) than in other groups. Patients with positive either RF or ACPA or both have more severe and aggressive disease that requires intensive treatment to improve outcomes.

Keywords

Rheumatoid arthritis Rheumatoid factor Anti-citrullinated peptide antibodies DAS28 HAQ 

Notes

Acknowledgments

We thank Ms. Khemajira Karaketklang, M.P.H., for statistical analysis; Ms. Wanwisa Chanapai, BSc (nursing), Mrs. Amolwan Dangarch, BSc (nursing), and Mrs. Kamolnate Chareonhongthong, BSc (nursing), MSc (Public health) for data collection and management; and Siriraj clinical trial unit for providing research coordinators. This work was supported by Siriraj research fund, Faculty of Medicine Siriraj Hospital, Mahidol University.

Conflict of interest

The authors declare no conflicts of interest.

References

  1. 1.
    Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, Combe B, Costenbader KH, Dougados M, Emery P, Ferraccioli G, Hazes JMW, Hobbs K, Huizinga TWJ, Kavanaugh A, Kay J, Kvien TK, Laing T, Mease P, Ménard HA, Moreland LW, Naden RL, Pincus T, Smolen JS, Stanislawska-Biernat E, Symmons D, Tak PP, Upchurch KS, Vencovský J, Wolfe F, Hawker G (2010) 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62:2569–2581. doi: 10.1002/art.27584 CrossRefPubMedGoogle Scholar
  2. 2.
    Nishimura K, Sugiyama D, Kogata Y, Tsuji G, Nakazawa T, Kawano S, Saigo K, Morinobu A, Koshiba M, Kuntz KM, Kamae I, Kumagai S (2007) Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis. Ann Intern Med 146:797–808CrossRefPubMedGoogle Scholar
  3. 3.
    Sun J, Zhang Y, Liu L, Liu G (2014) Diagnostic accuracy of combined tests of anti cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis: a meta-analysis. Clin Exp Rheumatol 32:11–21PubMedGoogle Scholar
  4. 4.
    Kroot EJ, de Jong BA, van Leeuwen MA, Swinkels H, van den Hoogen FH, van’t Hof M, van de Putte LB, van Rijswijk MH, van Venrooij WJ, van Riel PL (2000) The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis. Arthritis Rheum 43:1831–1835. doi: 10.1002/1529-0131(200008)43:8<1831:aid-anr19>3.0.co;2-6 CrossRefPubMedGoogle Scholar
  5. 5.
    Greiner A, Plischke H, Kellner H, Gruber R (2005) Association of anti-cyclic citrullinated peptide antibodies, anti-citrullin antibodies, and IgM and IgA rheumatoid factors with serological parameters of disease activity in rheumatoid arthritis. Ann N Y Acad Sci 1050:295–303. doi: 10.1196/annals.1313.031 CrossRefPubMedGoogle Scholar
  6. 6.
    Quinn MA, Gough AK, Green MJ, Devlin J, Hensor EM, Greenstein A, Fraser A, Emery P (2006) Anti-CCP antibodies measured at disease onset help identify seronegative rheumatoid arthritis and predict radiological and functional outcome. Rheumatology 45:478–480. doi: 10.1093/rheumatology/kei203 CrossRefPubMedGoogle Scholar
  7. 7.
    Guler H, Turhanoglu AD, Ozer B, Ozer C, Balci A (2008) The relationship between anti-cyclic citrullinated peptide and bone mineral density and radiographic damage in patients with rheumatoid arthritis. Scand J Rheumatol 37:337–342. doi: 10.1080/03009740801998812 CrossRefPubMedGoogle Scholar
  8. 8.
    Li H, Song W, Li Y, Liu Y, Bai J, Li X, Mu F, Wang Y, Zhang F, Su L (2010) Diagnostic value of anti-cyclic citrullinated peptide antibodies in northern Chinese Han patients with rheumatoid arthritis and its correlation with disease activity. Clin Rheumatol 29:413–417. doi: 10.1007/s10067-009-1337-2 CrossRefPubMedGoogle Scholar
  9. 9.
    Ibn Yacoub Y, Amine B, Laatiris A, Hajjaj-Hassouni N (2012) Rheumatoid factor and antibodies against citrullinated peptides in Moroccan patients with rheumatoid arthritis: association with disease parameters and quality of life. Clin Rheumatol 31:329–334. doi: 10.1007/s10067-011-1820-4 CrossRefPubMedGoogle Scholar
  10. 10.
    Shidara K, Inoue E, Hoshi D, Sato E, Nakajima A, Momohara S, Taniguchi A, Yamanaka H (2012) Anti-cyclic citrullinated peptide antibody predicts functional disability in patients with rheumatoid arthritis in a large prospective observational cohort in Japan. Rheumatol Int 32:361–366. doi: 10.1007/s00296-010-1671-3 CrossRefPubMedGoogle Scholar
  11. 11.
    Meyer O, Labarre C, Dougados M, Goupille P, Cantagrel A, Dubois A, Nicaise-Roland P, Sibilia J, Combe B (2003) Anticitrullinated protein/peptide antibody assays in early rheumatoid arthritis for predicting five year radiographic damage. Ann Rheum Dis 62:120–126PubMedCentralCrossRefPubMedGoogle Scholar
  12. 12.
    del Val del Amo N, Ibanez Bosch R, Fito Manteca C, Gutierrez Polo R, Loza Cortina E (2006) Anti-cyclic citrullinated peptide antibody in rheumatoid arthritis: relation with disease aggressiveness. Clin Exp Rheumatol 24:281–286PubMedGoogle Scholar
  13. 13.
    Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324CrossRefPubMedGoogle Scholar
  14. 14.
    Katchamart W, Ussavasodhi P, Chiowchanwesawakit P, Chanapai W (2013) Cross-cultural adaptation and validation of the Thai version of the Rheumatoid Arthritis Disease Activity Index (RADAI). Rheumatol Int 33:2503–2508. doi: 10.1007/s00296-013-2749-5 CrossRefPubMedGoogle Scholar
  15. 15.
    Osiri M, Deesomchok U, Tugwell P (2001) Evaluation of functional ability of Thai patients with rheumatoid arthritis by the use of a Thai version of the Health Assessment Questionnaire. Rheumatology 40:555–558CrossRefPubMedGoogle Scholar
  16. 16.
    Osiri M, Wongchinsri J, Ukritchon S, Hanvivadhanakul P, Kasitanon N, Siripaitoon B (2009) Comprehensibility, reliability, validity, and responsiveness of the Thai version of the Health Assessment Questionnaire in Thai patients with rheumatoid arthritis. Arthritis Res Ther 11:R129PubMedCentralCrossRefPubMedGoogle Scholar
  17. 17.
    Bas S, Genevay S, Meyer O, Gabay C (2003) Anti-cyclic citrullinated peptide antibodies, IgM and IgA rheumatoid factors in the diagnosis and prognosis of rheumatoid arthritis. Rheumatology 42:677–680CrossRefPubMedGoogle Scholar
  18. 18.
    Kastbom A, Strandberg G, Lindroos A, Skogh T (2004) Anti-CCP antibody test predicts the disease course during 3 years in early rheumatoid arthritis (the Swedish TIRA project). Ann Rheum Dis 63:1085–1089. doi: 10.1136/ard.2003.016808 PubMedCentralCrossRefPubMedGoogle Scholar
  19. 19.
    van der Helm-van Mil AH, Verpoort KN, Breedveld FC, Toes RE, Huizinga TW (2005) Antibodies to citrullinated proteins and differences in clinical progression of rheumatoid arthritis. Arthritis Res Ther 7:R949–R958. doi: 10.1186/ar1767 PubMedCentralCrossRefPubMedGoogle Scholar
  20. 20.
    Mewar D, Coote A, Moore DJ, Marinou I, Keyworth J, Dickson MC, Montgomery DS, Binks MH, Wilson AG (2006) Independent associations of anti-cyclic citrullinated peptide antibodies and rheumatoid factor with radiographic severity of rheumatoid arthritis. Arthritis Res Ther 8:R128PubMedCentralCrossRefPubMedGoogle Scholar
  21. 21.
    Diffin JG, Lunt M, Marshall T, Chipping JR, Symmons DPM, Verstappen SMM (2014) Has the severity of rheumatoid arthritis at presentation diminished over time? J Rheumatol 41:1590–1599. doi: 10.3899/jrheum.131136 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Wanruchada Katchamart
    • 1
    Email author
  • Ajchara Koolvisoot
    • 1
  • Emvalee Aromdee
    • 1
  • Praveena Chiowchanwesawakit
    • 1
  • Chayawee Muengchan
    • 1
  1. 1.Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand

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