Do you agree? We know there is a group of patients, perhaps 15 to 20% who seroconvert after 1 year. Perhaps their cohort is different. Rheumatol. 2013 Nov 15. [Epub ahead of print] Repeated Anticitrullinated Protein Antibody and Rheumatoid Factor Assessment Is Not Necessary in Early Arthritis: Results from the ESPOIR Cohort. Gossec L, Paternotte S, Combe B, Meyer O, Dougados M. Source From the Universite Pierre et Marie Curie, Paris; APHP, Pitie-Salpetriere Hospital, Department of Rheumatology, Paris; Paris Descartes University, Faculty of Medicine, Paris; APHP, Rheumatology B Department, Cochin Hospital, Paris; Department of Rheumatology, Lapeyronie Hospital, UMR 5535, Montpellier I University, Montpellier; Paris 7 Denis Diderot University, Paris; APHP, Bichat Hospital, Paris, France. Abstract OBJECTIVE: Presence and levels of anticyclic citrullinated peptide antibodies (anti-CCP) and rheumatoid factor (RF) contribute to the classification and prognosis of rheumatoid arthritis (RA). The objective was to determine the usefulness of repeating anti-CCP/RF measurements during the first 2 years of followup in patients with early arthritis. METHODS: In patients with early undifferentiated arthritis, serial anti-CCP and RF were measured using automated second-generation assays every 6 months for 2 years. Frequencies of seroconversions (from negative to positive or the reverse) and changes in antibody levels during followup were determined. RESULTS: In all, 775 patients, mean (SD) age 48.2 (12.5) years, mean symptom duration 3.4 (1.7) months, 76.6% female, were analyzed; 614 (79.2%) satisfied the American College of Rheumatology/European League Against Rheumatism 2010 classification criteria for RA at baseline. At baseline, respectively for anti-CCP and RF, 318 (41.0%) and 181 (23.4%) patients were positive, of whom 298 (93.7% of the positive) and 111 (61.3% of the positive) were highly positive (above 3 × upper limit of the norm). There were only 12 anti-CCP seroconversions toward the positive (i.e., 2.6% of the anti-CCP-negative), 21 seroconversions toward the negative (6.6% of the anti-CCP-positive), and 8 (1.0%) changes to a higher anti-CCP level category during the 2-year followup; respectively for RF, 27 (4.6%), 95 (52.5%), and 13 (1.7%). CONCLUSION: In this cohort of patients with early arthritis, including in the subset of patients who did not fulfill the RA criteria, antibody status showed little increase over a 2-year period. Repeated measurements of anti-CCP/RF very infrequently offer significant additional information.
Posted on: Sun, 01 Dec 2013 14:35:54 +0000
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