Missing Anticitrullinated Protein Antibody Does Not Affect Short-term Outcomes in Early Inflammatory Arthritis: From the Canadian Early Arthritis Cohort

The Journal of Rheumatology
Jenny ShuCATCH Investigators

Abstract

Anticitrullinated protein antibody (ACPA) is as sensitive as, but more specific than, rheumatoid factor (RF) and is detected earlier in rheumatoid arthritis (RA). Although part of the RA classification criteria, ACPA testing is not routinely paid for/accessible in all jurisdictions. The effect of missing ACPA testing was studied to determine whether failure to perform ACPA testing could cause a care gap in early inflammatory arthritis. Nearly 2000 patients (n = 1998) recruited to an early inflammatory arthritis cohort were allocated into 3 groups: (1) seropositive (either RF+ or ACPA+), (2) seronegative (RF- and ACPA-), and (3) missing ACPA and RF-. Analyses were adjusted for age, sex, symptom duration, and smoking status if p < 0.1. Disease Activity Score at 28 joints (DAS28) at 3 months was studied, because beyond then, disease activity is expected to determine ongoing treatment. More seropositive patients fulfilled the 2010 American College of Rheumatology/European League Against Rheumatism RA criteria than seronegative patients. Group 3 was slightly older and had a smaller percentage of females, as well as shorter symptom duration and less smoking. At 3 months, group 3 was treated with fewer disease-modifying antirheumatic ...Continue Reading

References

Jul 1, 1964·Annals of the Rheumatic Diseases·R L NIENHUIS, E MANDEMA
Oct 15, 2003·Arthritis and Rheumatism·Solbritt Rantapää-DahlqvistWalther J van Venrooij
Sep 19, 2006·Journal of Clinical Epidemiology·A Rogier T DondersKarel G M Moons
Oct 31, 2009·Arthritis and Rheumatism·Rohit AggarwalKaren H Costenbader
Mar 20, 2010·Arthritis Research & Therapy·Ger Jm PruijnWalther J van Venrooij
Aug 24, 2010·Autoimmunity Reviews·Allan S WiikGer J M Pruijn
Jul 28, 2011·Arthritis and Rheumatism·Lotte A van de StadtDirkjan van Schaardenburg
Oct 15, 2011·Annals of the Rheumatic Diseases·Annemiek WillemzeLeendert A Trouw
Jun 26, 2012·Clinical Chemistry·Patrick M M BossuytKarel G M Moons

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Citations

Sep 24, 2016·Annals of the Rheumatic Diseases·Annette H M van der Helm-van Mil, Angela Zink
Nov 3, 2015·The Journal of Rheumatology·Kevin D Deane

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