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Anti-citrullinated peptide antibodies are the strongest predictor of clinically relevant radiographic progression in rheumatoid arthritis patients achieving remission or low disease activity: A post hoc analysis of a nationwide cohort in Japan.

Authors :
Koga, Tomohiro
Okada, Akitomo
Fukuda, Takaaki
Hidaka, Toshihiko
Ishii, Tomonori
Ueki, Yukitaka
Kodera, Takao
Nakashima, Munetoshi
Takahashi, Yuichi
Honda, Seiyo
Horai, Yoshiro
Watanabe, Ryu
Okuno, Hiroshi
Aramaki, Toshiyuki
Izumiyama, Tomomasa
Takai, Osamu
Miyashita, Taiichiro
Sato, Shuntaro
Kawashiri, Shin-ya
Iwamoto, Naoki
Source :
PLoS ONE; 5/15/2017, Vol. 12 Issue 5, p1-13, 13p
Publication Year :
2017

Abstract

Objectives: To determine prognostic factors of clinically relevant radiographic progression (CRRP) in patients with rheumatoid arthritis (RA) achieving remission or low disease activity (LDA) in clinical practice. Methods: Using data from a nationwide, multicenter, prospective study in Japan, we evaluated 198 biological disease-modifying antirheumatic drug (bDMARD)-naïve RA patients who were in remission or had LDA at study entry after being treated with conventional synthetic DMARDs (csDMARDs). CRRP was defined as the yearly progression of modified total Sharp score (mTSS) >3.0 U. We performed a multiple logistic regression analysis to explore the factors to predict CRRP at 1 year. We used receiver operating characteristic (ROC) curve to estimate the performance of relevant variables for predicting CRRP. Results: The mean Disease Activity Score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR) was 2.32 ± 0.58 at study entry. During the 1-year observation, remission or LDA persisted in 72% of the patients. CRRP was observed in 7.6% of the patients. The multiple logistic regression analysis revealed that the independent variables to predict the development of CRRP were: anti-citrullinated peptide antibodies (ACPA) positivity at baseline (OR = 15.2, 95%CI 2.64–299), time-integrated DAS28-ESR during the 1 year post-baseline (7.85-unit increase, OR = 1.83, 95%CI 1.03–3.45), and the mTSS at baseline (13-unit increase, OR = 1.22, 95%CI 1.06–1.42). Conclusions: ACPA positivity was the strongest independent predictor of CRRP in patients with RA in remission or LDA. Physicians should recognize ACPA as a poor-prognosis factor regarding the radiographic outcome of RA, even among patients showing a clinically favorable response to DMARDs. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
19326203
Volume :
12
Issue :
5
Database :
Complementary Index
Journal :
PLoS ONE
Publication Type :
Academic Journal
Accession number :
123047707
Full Text :
https://doi.org/10.1371/journal.pone.0175281