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Anti-cyclic citrullinated peptide antibody predicts the development of rheumatoid arthritis in patients with undifferentiated arthritis

BACKGROUND: Clinical outcomes of undifferentiated arthritis (UA) are diverse, and only 40% of patients with UA develop rheumatoid arthritis (RA) after 3 years. Discovering predictive markers at disease onset for further intervention is critical. Therefore, our objective was to analyze the clinical o...

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Detalles Bibliográficos
Autores principales: Li, Chun, Zhang, Yan, Song, Hui, Gao, Jie, Zhao, Dong-Bao, Zhu, Qi, He, Dong-Yi, Wang, Li, Li, Xiang-Pei, Liu, Xu-Dong, Xiao, Wei-Guo, Wu, Xin-Yu, Wu, Hua-Xiang, Tu, Wei, Hu, Shao-Xian, Wang, Xin, Li, Zhi-Jun, Lu, Zhi-Min, Da, Zhan-Yun, Liang, Bo, Liu, Xiao-Min, Zhao, Jin-Wei, Li, Ling, Han, Feng, Qi, Wu-Fang, Wei, Wei, Ma, Xu, Li, Zhen-Bin, Zheng, Gui-Min, Zhang, Feng-Xiao, Li, Yi, Wang, You-Lian, Ling, Guang-Hui, Chen, Jin-Wei, Hou, Xiao-Qiang, Zhang, Jing, Chen, Qing-Ping, Liu, Chang-Lian, Zeng, Jia-Shun, Zou, Qing-Hua, Fang, Yong-Fei, Su, Yin, Li, Zhan-Guo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6964957/
https://www.ncbi.nlm.nih.gov/pubmed/31855969
http://dx.doi.org/10.1097/CM9.0000000000000570
Descripción
Sumario:BACKGROUND: Clinical outcomes of undifferentiated arthritis (UA) are diverse, and only 40% of patients with UA develop rheumatoid arthritis (RA) after 3 years. Discovering predictive markers at disease onset for further intervention is critical. Therefore, our objective was to analyze the clinical outcomes of UA and ascertain the predictors for RA development. METHODS: We performed a prospective, multi-center study from January 2013 to October 2016 among Chinese patients diagnosed with UA in 22 tertiary-care hospitals. Clinical and serological parameters were obtained at recruitment. Follow-up was undertaken in all patients every 12 weeks for 2 years. Predictive factors of disease progression were identified using multivariate Cox proportional hazards regression. RESULTS: A total of 234 patients were recruited in this study, and 17 (7.3%) patients failed to follow up during the study. Among the 217 patients who completed the study, 83 (38.2%) patients went into remission. UA patients who developed RA had a higher rheumatoid factor (RF)-positivity (42.9% vs. 16.8%, χ(2) = 8.228, P = 0.008), anti-cyclic citrullinated peptide (CCP) antibody-positivity (66.7% vs. 10.7%, χ(2) = 43.897, P < 0.001), and double-positivity rate of RF and anti-CCP antibody (38.1% vs. 4.1%, χ(2) = 32.131, P < 0.001) than those who did not. Anti-CCP antibody but not RF was an independent predictor for RA development (hazard ratio 18.017, 95% confidence interval: 5.803–55.938; P < 0.001). CONCLUSION: As an independent predictor of RA, anti-CCP antibody should be tested at disease onset in all patients with UA.