RESEARCH - Antibodies against MCV are a better predictor of disease activity in early RA than anti-CCP antibodies

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J Rheumatol. 2008 Apr 1

Antibodies Against Mutated Citrullinated Vimentin Are a Better

Predictor of Disease Activity at 24 Months in Early Rheumatoid

Arthritis Than Antibodies Against Cyclic Citrullinated Peptides.

Innala L, Kokkonen H, sson C, Jidell E, Berglin E, Dahlqvst SR.

From the Department of Rheumatology, Department of Clinical

Immunology, and Department of Transfusion Medicine, University

Hospital, Umeå, Sweden.

OBJECTIVE: To evaluate the predictive values for disease progression

of various antibodies against citrullinated peptide proteins (ACPA)

and their relation to PTPN22 1858C/T polymorphism and HLA-DRB1 alleles

in early rheumatoid arthritis (RA). METHODS: The ACPA, e.g.,

antibodies against mutated citrullinated vimentin (MCV), cyclic

citrullinated peptides (CCP) type 2 and 3 (both of IgG isotype) and

3.1 (of both IgG and IgA isotypes), were analyzed at baseline in

patients with early RA (n = 210) and in population controls (n = 102)

using an enzyme immunoassay. A receiver-operating characteristic curve

was constructed for each antibody. Disease activity [swollen and

tender joints, visual analog scale for global health, and erythrocyte

sedimentation rate (ESR)] was evaluated at baseline and regularly for

24 months. Radiographs of hands and feet were graded using the Larsen

score. RESULTS: Patients with anti-MCV antibodies had significantly

less reduction in Disease Activity Score (DAS28) over time (p < 0.01),

and significantly increased area under the curve (AUC) for DAS28 (p <

0.05), ESR (p < 0.01), C-reactive protein (p < 0.01), and swollen

joint count (p = 0.057) compared to those without. Corresponding

differences were not found in patients with anti-CCP2, CCP3, and

CCP3.1 antibodies. Radiological progression (p < 0.0001-0.01) and

radiological outcome (p < 0.0001-0.01) at 24 months were significantly

predicted by all ACPA after baseline adjustments. PTPN22 T variant and

HLA-DRB1 alleles were not related to radiological progression or

inflammatory activity over time. CONCLUSION: Anti-MCV antibodies are

associated with a more severe RA disease, as measured by DAS28, ESR,

and swollen joint count over time, compared with anti-CCP2, CCP3, and

CCP3.1 antibodies. Radiological progression was predicted equally by

all 4 autoantibodies.

PMID: 18398946

http://www.ncbi.nlm.nih.gov/pubmed/18398946

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