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

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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@...

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

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