Re: Prediction of radiological outcome in early RA: role of anti-CCP

August 16, 2004

What is " anti-cyclic citrullinated peptide antibody (anti-CCP) " ?????

Is this something they can do a blood test to determine if you have?

And I can't tell for sure, is having it a good thing or a bad thing?

Is it something they could test you for early and see if you will get

joint damage, or that they test you for later to see if you have

experienced joint damage? I think the former, but again, I am not

sure from reading the article. Any clarification would be helpful.

Jennie

> Ann Rheum Dis. 2004 Sep;63(9):1090-5.

>

> Prediction of radiological outcome in early rheumatoid arthritis in

> clinical practice: role of antibodies to citrullinated peptides

> (anti-CCP).

>

> Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B.

>

> Blistorpsvagen 105, 290 38 Villands Vanga, Sweden.

> bjoern.svensson@s...

>

> OBJECTIVE: To investigate the role of anti-cyclic citrullinated

peptide

> antibody (anti-CCP) for the prediction of radiological outcome in

> patients with early rheumatoid arthritis. METHODS: Anti-CCP was

assessed

> at baseline in 379 patients with early rheumatoid arthritis (disease

> duration <1 year). Radiological joint damage and progression were

> assessed by Larsen score after two years of follow up (end point)

and

> used as outcome variables. The prognostic value of anti-CCP and

other

> demographic and disease related baseline variables were assessed by

> univariate and multivariate analyses, including calculation of odds

> ratios (OR), predictive values, and multiple logistic regression

models.

> RESULTS: The presence of anti-CCP was associated with significantly

> higher Larsen score both at baseline and at end point. Univariate

> predictor analysis showed that anti-CCP had the highest significant

OR

> for radiological joint damage and progression after baseline Larsen

> score, followed by rheumatoid factor, erythrocyte sedimentation rate

> (ESR), C reactive protein, age, smoking status, and sex. In stepwise

> multiple regression analyses, baseline Larsen score, anti-CCP, and

ESR

> were selected as significant independent predictors of the

radiological

> outcomes.

>

> CONCLUSIONS: There is good evidence for an association of anti-CCP

with

> radiological joint changes in rheumatoid arthritis. Anti-CCP is an

> independent predictor of radiological damage and progression. Though

> prediction in early rheumatoid arthritis is still far from perfect,

the

> use of anti-CCP in clinical practice should make it easier for

> rheumatologists to reach judicious treatment decisions.

>

> PMID: 15308518

>

> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org

August 16, 2004

What is " anti-cyclic citrullinated peptide antibody (anti-CCP) " ?????

Is this something they can do a blood test to determine if you have?

And I can't tell for sure, is having it a good thing or a bad thing?

Is it something they could test you for early and see if you will get

joint damage, or that they test you for later to see if you have

experienced joint damage? I think the former, but again, I am not

sure from reading the article. Any clarification would be helpful.

Jennie

> Ann Rheum Dis. 2004 Sep;63(9):1090-5.

>

> Prediction of radiological outcome in early rheumatoid arthritis in

> clinical practice: role of antibodies to citrullinated peptides

> (anti-CCP).

>

> Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B.

>

> Blistorpsvagen 105, 290 38 Villands Vanga, Sweden.

> bjoern.svensson@s...

>

> OBJECTIVE: To investigate the role of anti-cyclic citrullinated

peptide

> antibody (anti-CCP) for the prediction of radiological outcome in

> patients with early rheumatoid arthritis. METHODS: Anti-CCP was

assessed

> at baseline in 379 patients with early rheumatoid arthritis (disease

> duration <1 year). Radiological joint damage and progression were

> assessed by Larsen score after two years of follow up (end point)

and

> used as outcome variables. The prognostic value of anti-CCP and

other

> demographic and disease related baseline variables were assessed by

> univariate and multivariate analyses, including calculation of odds

> ratios (OR), predictive values, and multiple logistic regression

models.

> RESULTS: The presence of anti-CCP was associated with significantly

> higher Larsen score both at baseline and at end point. Univariate

> predictor analysis showed that anti-CCP had the highest significant

OR

> for radiological joint damage and progression after baseline Larsen

> score, followed by rheumatoid factor, erythrocyte sedimentation rate

> (ESR), C reactive protein, age, smoking status, and sex. In stepwise

> multiple regression analyses, baseline Larsen score, anti-CCP, and

ESR

> were selected as significant independent predictors of the

radiological

> outcomes.

>

> CONCLUSIONS: There is good evidence for an association of anti-CCP

with

> radiological joint changes in rheumatoid arthritis. Anti-CCP is an

> independent predictor of radiological damage and progression. Though

> prediction in early rheumatoid arthritis is still far from perfect,

the

> use of anti-CCP in clinical practice should make it easier for

> rheumatologists to reach judicious treatment decisions.

>

> PMID: 15308518

>

> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org

August 16, 2004

Jennie, yes, there are blood tests your rheumatologist can order to

detect the presence of antibodies to citrullinated peptides in your

serum (several versions are available).

Would it be politically incorrect to say that having these antibodies is

a bad thing, LOL? I'll go out on a limb and say that the average person

wouldn't want these antibodies since, if they are present, then RA is

the most likely diagnosis. An anti-CCP-positive person would also be

statistically more likely to have erosive disease than someone with RA

who is anti-CCP-negative.

As you know, early diagnosis and treatment of RA is very important, and

the search for better diagnostic and prognostic tools has been underway

for years.

In this particular study, they used an ELISA CCP2 test and it

outperformed RF; however, as a predictor of radiological outcome after

two years in this study, the baseline Larsen score (based on x-rays) was

more important than the results of the anti-CCP test.

It's important to keep in mind that it is not a perfect test. An

individual could have RA and test negative for anti-CCP. A person could

test positive for anti-CCP and not develop more severe joint damage than

someone with RA who is anti-CCP-negative. Same old problem!

Anti-CCP can be very helpful in making an RA diagnosis and in judging

the prognosis though, especially when used in conjunction with the other

tests and markers we already have.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Re: Prediction of radiological outcome in early

RA: role of anti-CCP

> What is " anti-cyclic citrullinated peptide antibody (anti-CCP) " ?????

> Is this something they can do a blood test to determine if you have?

> And I can't tell for sure, is having it a good thing or a bad thing?

> Is it something they could test you for early and see if you will get

> joint damage, or that they test you for later to see if you have

> experienced joint damage? I think the former, but again, I am not

> sure from reading the article. Any clarification would be helpful.

>

> Jennie

>

> > Ann Rheum Dis. 2004 Sep;63(9):1090-5.

> >

> > Prediction of radiological outcome in early rheumatoid arthritis in

> > clinical practice: role of antibodies to citrullinated peptides

> > (anti-CCP).

> >

> > Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B.

> >

> > Blistorpsvagen 105, 290 38 Villands Vanga, Sweden.

> > bjoern.svensson@s...

> >

> > OBJECTIVE: To investigate the role of anti-cyclic citrullinated

> peptide

> > antibody (anti-CCP) for the prediction of radiological outcome in

> > patients with early rheumatoid arthritis. METHODS: Anti-CCP was

> assessed

> > at baseline in 379 patients with early rheumatoid arthritis (disease

> > duration <1 year). Radiological joint damage and progression were

> > assessed by Larsen score after two years of follow up (end point)

> and

> > used as outcome variables. The prognostic value of anti-CCP and

> other

> > demographic and disease related baseline variables were assessed by

> > univariate and multivariate analyses, including calculation of odds

> > ratios (OR), predictive values, and multiple logistic regression

> models.

> > RESULTS: The presence of anti-CCP was associated with significantly

> > higher Larsen score both at baseline and at end point. Univariate

> > predictor analysis showed that anti-CCP had the highest significant

> OR

> > for radiological joint damage and progression after baseline Larsen

> > score, followed by rheumatoid factor, erythrocyte sedimentation rate

> > (ESR), C reactive protein, age, smoking status, and sex. In stepwise

> > multiple regression analyses, baseline Larsen score, anti-CCP, and

> ESR

> > were selected as significant independent predictors of the

> radiological

> > outcomes.

> >

> > CONCLUSIONS: There is good evidence for an association of anti-CCP

> with

> > radiological joint changes in rheumatoid arthritis. Anti-CCP is an

> > independent predictor of radiological damage and progression. Though

> > prediction in early rheumatoid arthritis is still far from perfect,

> the

> > use of anti-CCP in clinical practice should make it easier for

> > rheumatologists to reach judicious treatment decisions.

> >

> > PMID: 15308518

> >

August 16, 2004

Jennie, yes, there are blood tests your rheumatologist can order to

detect the presence of antibodies to citrullinated peptides in your

serum (several versions are available).

Would it be politically incorrect to say that having these antibodies is

a bad thing, LOL? I'll go out on a limb and say that the average person

wouldn't want these antibodies since, if they are present, then RA is

the most likely diagnosis. An anti-CCP-positive person would also be

statistically more likely to have erosive disease than someone with RA

who is anti-CCP-negative.

As you know, early diagnosis and treatment of RA is very important, and

the search for better diagnostic and prognostic tools has been underway

for years.

In this particular study, they used an ELISA CCP2 test and it

outperformed RF; however, as a predictor of radiological outcome after

two years in this study, the baseline Larsen score (based on x-rays) was

more important than the results of the anti-CCP test.

It's important to keep in mind that it is not a perfect test. An

individual could have RA and test negative for anti-CCP. A person could

test positive for anti-CCP and not develop more severe joint damage than

someone with RA who is anti-CCP-negative. Same old problem!

Anti-CCP can be very helpful in making an RA diagnosis and in judging

the prognosis though, especially when used in conjunction with the other

tests and markers we already have.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Re: Prediction of radiological outcome in early

RA: role of anti-CCP

> What is " anti-cyclic citrullinated peptide antibody (anti-CCP) " ?????

> Is this something they can do a blood test to determine if you have?

> And I can't tell for sure, is having it a good thing or a bad thing?

> Is it something they could test you for early and see if you will get

> joint damage, or that they test you for later to see if you have

> experienced joint damage? I think the former, but again, I am not

> sure from reading the article. Any clarification would be helpful.

>

> Jennie

>

> > Ann Rheum Dis. 2004 Sep;63(9):1090-5.

> >

> > Prediction of radiological outcome in early rheumatoid arthritis in

> > clinical practice: role of antibodies to citrullinated peptides

> > (anti-CCP).

> >

> > Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B.

> >

> > Blistorpsvagen 105, 290 38 Villands Vanga, Sweden.

> > bjoern.svensson@s...

> >

> > OBJECTIVE: To investigate the role of anti-cyclic citrullinated

> peptide

> > antibody (anti-CCP) for the prediction of radiological outcome in

> > patients with early rheumatoid arthritis. METHODS: Anti-CCP was

> assessed

> > at baseline in 379 patients with early rheumatoid arthritis (disease

> > duration <1 year). Radiological joint damage and progression were

> > assessed by Larsen score after two years of follow up (end point)

> and

> > used as outcome variables. The prognostic value of anti-CCP and

> other

> > demographic and disease related baseline variables were assessed by

> > univariate and multivariate analyses, including calculation of odds

> > ratios (OR), predictive values, and multiple logistic regression

> models.

> > RESULTS: The presence of anti-CCP was associated with significantly

> > higher Larsen score both at baseline and at end point. Univariate

> > predictor analysis showed that anti-CCP had the highest significant

> OR

> > for radiological joint damage and progression after baseline Larsen

> > score, followed by rheumatoid factor, erythrocyte sedimentation rate

> > (ESR), C reactive protein, age, smoking status, and sex. In stepwise

> > multiple regression analyses, baseline Larsen score, anti-CCP, and

> ESR

> > were selected as significant independent predictors of the

> radiological

> > outcomes.

> >

> > CONCLUSIONS: There is good evidence for an association of anti-CCP

> with

> > radiological joint changes in rheumatoid arthritis. Anti-CCP is an

> > independent predictor of radiological damage and progression. Though

> > prediction in early rheumatoid arthritis is still far from perfect,

> the

> > use of anti-CCP in clinical practice should make it easier for

> > rheumatologists to reach judicious treatment decisions.

> >

> > PMID: 15308518

> >

August 17, 2004

,

Do you know if someone with RA would have the antibodies before they

actually develop RA? For example, I got RA at age 32 - would I have

had the CPP when I was a child if the test had been available then?

Or do you just develop the antibodies when you develop RA?

I prescribe to the theory you need an environmental trigger to bring

the RA on... however, I am hopeful they will find a way to test if

one has the RA gene. If you knew you had the gene, then you could

live your life in a way to try and avoid a trigger for the disease.

Since RA runs in my family, I am mostly thinking of my niece and my

daughter.

Jennie

> > > Ann Rheum Dis. 2004 Sep;63(9):1090-5.

> > >

> > > Prediction of radiological outcome in early rheumatoid

arthritis in

> > > clinical practice: role of antibodies to citrullinated peptides

> > > (anti-CCP).

> > >

> > > Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B.

> > >

> > > Blistorpsvagen 105, 290 38 Villands Vanga, Sweden.

> > > bjoern.svensson@s...

> > >

> > > OBJECTIVE: To investigate the role of anti-cyclic citrullinated

> > peptide

> > > antibody (anti-CCP) for the prediction of radiological outcome

in

> > > patients with early rheumatoid arthritis. METHODS: Anti-CCP was

> > assessed

> > > at baseline in 379 patients with early rheumatoid arthritis

(disease

> > > duration <1 year). Radiological joint damage and progression

were

> > > assessed by Larsen score after two years of follow up (end

point)

> > and

> > > used as outcome variables. The prognostic value of anti-CCP and

> > other

> > > demographic and disease related baseline variables were

assessed by

> > > univariate and multivariate analyses, including calculation of

odds

> > > ratios (OR), predictive values, and multiple logistic regression

> > models.

> > > RESULTS: The presence of anti-CCP was associated with

significantly

> > > higher Larsen score both at baseline and at end point.

Univariate

> > > predictor analysis showed that anti-CCP had the highest

significant

> > OR

> > > for radiological joint damage and progression after baseline

Larsen

> > > score, followed by rheumatoid factor, erythrocyte sedimentation

rate

> > > (ESR), C reactive protein, age, smoking status, and sex. In

stepwise

> > > multiple regression analyses, baseline Larsen score, anti-CCP,

and

> > ESR

> > > were selected as significant independent predictors of the

> > radiological

> > > outcomes.

> > >

> > > CONCLUSIONS: There is good evidence for an association of anti-

CCP

> > with

> > > radiological joint changes in rheumatoid arthritis. Anti-CCP is

an

> > > independent predictor of radiological damage and progression.

Though

> > > prediction in early rheumatoid arthritis is still far from

perfect,

> > the

> > > use of anti-CCP in clinical practice should make it easier for

> > > rheumatologists to reach judicious treatment decisions.

> > >

> > > PMID: 15308518

> > >

August 17, 2004

,

Do you know if someone with RA would have the antibodies before they

actually develop RA? For example, I got RA at age 32 - would I have

had the CPP when I was a child if the test had been available then?

Or do you just develop the antibodies when you develop RA?

I prescribe to the theory you need an environmental trigger to bring

the RA on... however, I am hopeful they will find a way to test if

one has the RA gene. If you knew you had the gene, then you could

live your life in a way to try and avoid a trigger for the disease.

Since RA runs in my family, I am mostly thinking of my niece and my

daughter.

Jennie

> > > Ann Rheum Dis. 2004 Sep;63(9):1090-5.

> > >

> > > Prediction of radiological outcome in early rheumatoid

arthritis in

> > > clinical practice: role of antibodies to citrullinated peptides

> > > (anti-CCP).

> > >

> > > Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B.

> > >

> > > Blistorpsvagen 105, 290 38 Villands Vanga, Sweden.

> > > bjoern.svensson@s...

> > >

> > > OBJECTIVE: To investigate the role of anti-cyclic citrullinated

> > peptide

> > > antibody (anti-CCP) for the prediction of radiological outcome

in

> > > patients with early rheumatoid arthritis. METHODS: Anti-CCP was

> > assessed

> > > at baseline in 379 patients with early rheumatoid arthritis

(disease

> > > duration <1 year). Radiological joint damage and progression

were

> > > assessed by Larsen score after two years of follow up (end

point)

> > and

> > > used as outcome variables. The prognostic value of anti-CCP and

> > other

> > > demographic and disease related baseline variables were

assessed by

> > > univariate and multivariate analyses, including calculation of

odds

> > > ratios (OR), predictive values, and multiple logistic regression

> > models.

> > > RESULTS: The presence of anti-CCP was associated with

significantly

> > > higher Larsen score both at baseline and at end point.

Univariate

> > > predictor analysis showed that anti-CCP had the highest

significant

> > OR

> > > for radiological joint damage and progression after baseline

Larsen

> > > score, followed by rheumatoid factor, erythrocyte sedimentation

rate

> > > (ESR), C reactive protein, age, smoking status, and sex. In

stepwise

> > > multiple regression analyses, baseline Larsen score, anti-CCP,

and

> > ESR

> > > were selected as significant independent predictors of the

> > radiological

> > > outcomes.

> > >

> > > CONCLUSIONS: There is good evidence for an association of anti-

CCP

> > with

> > > radiological joint changes in rheumatoid arthritis. Anti-CCP is

an

> > > independent predictor of radiological damage and progression.

Though

> > > prediction in early rheumatoid arthritis is still far from

perfect,

> > the

> > > use of anti-CCP in clinical practice should make it easier for

> > > rheumatologists to reach judicious treatment decisions.

> > >

> > > PMID: 15308518

> > >

August 17, 2004

Jennie,

I believe that I got RA from a parasite or whatever when we were in Mexico.

I was diagnosed 6 months later without ever having had any symtoms

whatsoever. Also, there is no RA in any part of my family so it came as a

complete shock. It also came on very acutely. No sign of it before.

I will speak to my doctor about enbrel when I go next month. My

chiropractor is doing some research for me as well.

ette

August 17, 2004

Jennie,

I believe that I got RA from a parasite or whatever when we were in Mexico.

I was diagnosed 6 months later without ever having had any symtoms

whatsoever. Also, there is no RA in any part of my family so it came as a

complete shock. It also came on very acutely. No sign of it before.

I will speak to my doctor about enbrel when I go next month. My

chiropractor is doing some research for me as well.

ette

August 17, 2004

, I have a related question. Do you know if the anti-CCP test

results are affected by treatment or lack of treatment (like having

your sed rate decrease once you start treatment)? OR is it something

you either have or don't have, so if your test comes back positive

there's really no reason to test again? I think the anti-ccp was the

test that led my doctor to change my dx from some unidentified

arthritis to RA.

> > > > Ann Rheum Dis. 2004 Sep;63(9):1090-5.

> > > >

> > > > Prediction of radiological outcome in early rheumatoid

> arthritis in

> > > > clinical practice: role of antibodies to citrullinated

peptides

> > > > (anti-CCP).

> > > >

> > > > Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B.

> > > >

> > > > Blistorpsvagen 105, 290 38 Villands Vanga, Sweden.

> > > > bjoern.svensson@s...

> > > >

> > > > OBJECTIVE: To investigate the role of anti-cyclic

citrullinated

> > > peptide

> > > > antibody (anti-CCP) for the prediction of radiological

outcome

> in

> > > > patients with early rheumatoid arthritis. METHODS: Anti-CCP

was

> > > assessed

> > > > at baseline in 379 patients with early rheumatoid arthritis

> (disease

> > > > duration <1 year). Radiological joint damage and progression

> were

> > > > assessed by Larsen score after two years of follow up (end

> point)

> > > and

> > > > used as outcome variables. The prognostic value of anti-CCP

and

> > > other

> > > > demographic and disease related baseline variables were

> assessed by

> > > > univariate and multivariate analyses, including calculation

of

> odds

> > > > ratios (OR), predictive values, and multiple logistic

regression

> > > models.

> > > > RESULTS: The presence of anti-CCP was associated with

> significantly

> > > > higher Larsen score both at baseline and at end point.

> Univariate

> > > > predictor analysis showed that anti-CCP had the highest

> significant

> > > OR

> > > > for radiological joint damage and progression after baseline

> Larsen

> > > > score, followed by rheumatoid factor, erythrocyte

sedimentation

> rate

> > > > (ESR), C reactive protein, age, smoking status, and sex. In

> stepwise

> > > > multiple regression analyses, baseline Larsen score, anti-

CCP,

> and

> > > ESR

> > > > were selected as significant independent predictors of the

> > > radiological

> > > > outcomes.

> > > >

> > > > CONCLUSIONS: There is good evidence for an association of

anti-

> CCP

> > > with

> > > > radiological joint changes in rheumatoid arthritis. Anti-CCP

is

> an

> > > > independent predictor of radiological damage and progression.

> Though

> > > > prediction in early rheumatoid arthritis is still far from

> perfect,

> > > the

> > > > use of anti-CCP in clinical practice should make it easier for

> > > > rheumatologists to reach judicious treatment decisions.

> > > >

> > > > PMID: 15308518

> > > >

August 17, 2004

, I have a related question. Do you know if the anti-CCP test

results are affected by treatment or lack of treatment (like having

your sed rate decrease once you start treatment)? OR is it something

you either have or don't have, so if your test comes back positive

there's really no reason to test again? I think the anti-ccp was the

test that led my doctor to change my dx from some unidentified

arthritis to RA.

> > > > Ann Rheum Dis. 2004 Sep;63(9):1090-5.

> > > >

> > > > Prediction of radiological outcome in early rheumatoid

> arthritis in

> > > > clinical practice: role of antibodies to citrullinated

peptides

> > > > (anti-CCP).

> > > >

> > > > Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B.

> > > >

> > > > Blistorpsvagen 105, 290 38 Villands Vanga, Sweden.

> > > > bjoern.svensson@s...

> > > >

> > > > OBJECTIVE: To investigate the role of anti-cyclic

citrullinated

> > > peptide

> > > > antibody (anti-CCP) for the prediction of radiological

outcome

> in

> > > > patients with early rheumatoid arthritis. METHODS: Anti-CCP

was

> > > assessed

> > > > at baseline in 379 patients with early rheumatoid arthritis

> (disease

> > > > duration <1 year). Radiological joint damage and progression

> were

> > > > assessed by Larsen score after two years of follow up (end

> point)

> > > and

> > > > used as outcome variables. The prognostic value of anti-CCP

and

> > > other

> > > > demographic and disease related baseline variables were

> assessed by

> > > > univariate and multivariate analyses, including calculation

of

> odds

> > > > ratios (OR), predictive values, and multiple logistic

regression

> > > models.

> > > > RESULTS: The presence of anti-CCP was associated with

> significantly

> > > > higher Larsen score both at baseline and at end point.

> Univariate

> > > > predictor analysis showed that anti-CCP had the highest

> significant

> > > OR

> > > > for radiological joint damage and progression after baseline

> Larsen

> > > > score, followed by rheumatoid factor, erythrocyte

sedimentation

> rate

> > > > (ESR), C reactive protein, age, smoking status, and sex. In

> stepwise

> > > > multiple regression analyses, baseline Larsen score, anti-

CCP,

> and

> > > ESR

> > > > were selected as significant independent predictors of the

> > > radiological

> > > > outcomes.

> > > >

> > > > CONCLUSIONS: There is good evidence for an association of

anti-

> CCP

> > > with

> > > > radiological joint changes in rheumatoid arthritis. Anti-CCP

is

> an

> > > > independent predictor of radiological damage and progression.

> Though

> > > > prediction in early rheumatoid arthritis is still far from

> perfect,

> > > the

> > > > use of anti-CCP in clinical practice should make it easier for

> > > > rheumatologists to reach judicious treatment decisions.

> > > >

> > > > PMID: 15308518

> > > >

August 17, 2004

Well, Jennie, you may not be positive for anti-CCP now. Remember, not

everyone with RA is.

There is evidence that some people develop antibodies long before they

have any signs or symptoms of illness; however, there are also people

who have certain antibodies who are seemingly quite healthy. For

example, about 10% of people who test positive for ANA do not have a

disease.

I am not aware of much good data on what antibodies are present in

children and what that implies for their future health. Also, even if

anti-CCP positivity in childhood could predict adult RA, I'm not sure

too many doctors and parents would be willing to possibly

psychologically harm a child by hanging a sword of Damocles such as that

over them.

There are probably several genes and multiple triggers involved in the

development of RA, so it would be hard to know what to avoid. Obviously,

you can't avoid your genes - too late, LOL. Exercising, getting proper

sleep, eating a healthy diet, maintaining a normal weight, and not ever

smoking would be a very wise lifestyle for those with a lot of immune

system dysfunction in the family. Then again, who wouldn't benefit from

such an approach?

There is at least one identical twin in our group. She has RA and yet

her twin doesn't. There have been many twin studies that show that there

is a relatively low concordance rate for RA, so, although the genes are

important, environmental factors have a tremendous impact.

Unfortunately, we don't know what those external variables are. Smoking

does seem to be one of them.

We have to hope that we have the answers to the RA mystery soon and that

future generations will be spared.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Re: Prediction of radiological outcome in early

RA: role of anti-CCP

> ,

>

> Do you know if someone with RA would have the antibodies before they

> actually develop RA? For example, I got RA at age 32 - would I have

> had the CPP when I was a child if the test had been available then?

> Or do you just develop the antibodies when you develop RA?

>

> I prescribe to the theory you need an environmental trigger to bring

> the RA on... however, I am hopeful they will find a way to test if

> one has the RA gene. If you knew you had the gene, then you could

> live your life in a way to try and avoid a trigger for the disease.

> Since RA runs in my family, I am mostly thinking of my niece and my

> daughter.

>

> Jennie

August 17, 2004

Well, Jennie, you may not be positive for anti-CCP now. Remember, not

everyone with RA is.

There is evidence that some people develop antibodies long before they

have any signs or symptoms of illness; however, there are also people

who have certain antibodies who are seemingly quite healthy. For

example, about 10% of people who test positive for ANA do not have a

disease.

I am not aware of much good data on what antibodies are present in

children and what that implies for their future health. Also, even if

anti-CCP positivity in childhood could predict adult RA, I'm not sure

too many doctors and parents would be willing to possibly

psychologically harm a child by hanging a sword of Damocles such as that

over them.

There are probably several genes and multiple triggers involved in the

development of RA, so it would be hard to know what to avoid. Obviously,

you can't avoid your genes - too late, LOL. Exercising, getting proper

sleep, eating a healthy diet, maintaining a normal weight, and not ever

smoking would be a very wise lifestyle for those with a lot of immune

system dysfunction in the family. Then again, who wouldn't benefit from

such an approach?

There is at least one identical twin in our group. She has RA and yet

her twin doesn't. There have been many twin studies that show that there

is a relatively low concordance rate for RA, so, although the genes are

important, environmental factors have a tremendous impact.

Unfortunately, we don't know what those external variables are. Smoking

does seem to be one of them.

We have to hope that we have the answers to the RA mystery soon and that

future generations will be spared.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Re: Prediction of radiological outcome in early

RA: role of anti-CCP

> ,

>

> Do you know if someone with RA would have the antibodies before they

> actually develop RA? For example, I got RA at age 32 - would I have

> had the CPP when I was a child if the test had been available then?

> Or do you just develop the antibodies when you develop RA?

>

> I prescribe to the theory you need an environmental trigger to bring

> the RA on... however, I am hopeful they will find a way to test if

> one has the RA gene. If you knew you had the gene, then you could

> live your life in a way to try and avoid a trigger for the disease.

> Since RA runs in my family, I am mostly thinking of my niece and my

> daughter.

>

> Jennie

August 17, 2004

My daughter will grow up knowing she could get this disease. The

things I want to encourage her to do to avoid it (in addition to

never smoking, no brainer there) is exercising, eating healthy,

avoiding exposure to lots of household and other chemicals, not

having a high stress job, etc. Of course, you can't avoid any and

all stress. I just want her to be careful and be as healthy as she

can be. Living healthy is a good thing even if she doesn't have the

RA gene.

I think my trigger for RA was this one week where we had two deaths

in the family (one expected, one very much not expected), and I got a

horrible stomach virus... it went something like this: Monday

grandfather died, Wednesday learned of aunt's death (my daughters god

mother, she died Tuesday but was not found until Wednesday), Thursday

night baby got sick with stomach virus (right after I finished

packing at 1am), Friday am (with baby throwing up) flew to Colorado,

Friday afternoon attended grandfather's funeral, Friday night I

started getting sick from the stomach virus, Saturday attended sister-

in-laws wedding (the trip to Colorado was planned for the wedding,

funeral was held on Friday so I could attend), Sunday attended my

sister's baby shower, Monday flew home (baby and me still recovering

from virus), Tuesday attended second funeral and had everyone back at

our house after (which we were soooo prepared for). After this I

started loosing weight without changing anything about my lifestyle

and 9 months later RA symptoms started.

Oh, and during this time I was working for Andersen. A job in public

accounting is guaranteed to be stressful, but having your company

disintegrate around you and not knowing each day if that is the day

you'll be let go, was very stressful.

Jennie

> Well, Jennie, you may not be positive for anti-CCP now. Remember,

not

> everyone with RA is.

>

> There is evidence that some people develop antibodies long before

they

> have any signs or symptoms of illness; however, there are also

people

> who have certain antibodies who are seemingly quite healthy. For

> example, about 10% of people who test positive for ANA do not have a

> disease.

>

> I am not aware of much good data on what antibodies are present in

> children and what that implies for their future health. Also, even

if

> anti-CCP positivity in childhood could predict adult RA, I'm not

sure

> too many doctors and parents would be willing to possibly

> psychologically harm a child by hanging a sword of Damocles such as

that

> over them.

>

> There are probably several genes and multiple triggers involved in

the

> development of RA, so it would be hard to know what to avoid.

Obviously,

> you can't avoid your genes - too late, LOL. Exercising, getting

proper

> sleep, eating a healthy diet, maintaining a normal weight, and not

ever

> smoking would be a very wise lifestyle for those with a lot of

immune

> system dysfunction in the family. Then again, who wouldn't benefit

from

> such an approach?

>

> There is at least one identical twin in our group. She has RA and

yet

> her twin doesn't. There have been many twin studies that show that

there

> is a relatively low concordance rate for RA, so, although the genes

are

> important, environmental factors have a tremendous impact.

> Unfortunately, we don't know what those external variables are.

Smoking

> does seem to be one of them.

>

> We have to hope that we have the answers to the RA mystery soon and

that

> future generations will be spared.

>

> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org

>

> [ ] Re: Prediction of radiological outcome in

early

> RA: role of anti-CCP

>

> > ,

> >

> > Do you know if someone with RA would have the antibodies before

they

> > actually develop RA? For example, I got RA at age 32 - would I

have

> > had the CPP when I was a child if the test had been available

then?

> > Or do you just develop the antibodies when you develop RA?

> >

> > I prescribe to the theory you need an environmental trigger to

bring

> > the RA on... however, I am hopeful they will find a way to test if

> > one has the RA gene. If you knew you had the gene, then you could

> > live your life in a way to try and avoid a trigger for the

disease.

> > Since RA runs in my family, I am mostly thinking of my niece and

my

> > daughter.

> >

> > Jennie

August 17, 2004