Anticyclic Citrullinated Peptide Antibodies as Markers of Erosive Arthritis in Antisynthetase Syndrome: Table 1.

Cavagna, Lorenzo; Fusetti, C.; Montecucco, Carlomaurizio; Caporali, Roberto

doi:10.3899/jrheum.091402

Cited by 31 publications

(17 citation statements)

References 3 publications

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“…In these patients, ILD is described in up to 95% [20]. Arthritis is frequently symmetrical, and joint erosions and ACPA positivity have been described also in ASS patients [143], making the differential diagnosis between RA and ASS particularly challenging. Some reports indicate that the onset of different manifestations may be spread out [144, 145] with patients presenting first with arthritis and then with ILD.…”

Section: Differential Diagnosismentioning

confidence: 99%

The Multifaceted Aspects of Interstitial Lung Disease in Rheumatoid Arthritis

Cavagna

Monti

Grosso

et al. 2013

BioMed Research International

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Interstitial lung disease (ILD) is a relevant extra-articular manifestation of rheumatoid arthritis (RA) that may occur either in early stages or as a complication of long-standing disease. RA related ILD (RA-ILD) significantly influences the quoad vitam prognosis of these patients. Several histopathological patterns of RA-ILD have been described: usual interstitial pneumonia (UIP) is the most frequent one, followed by nonspecific interstitial pneumonia (NSIP); other patterns are less commonly observed. Several factors have been associated with an increased risk of developing RA-ILD. The genetic background plays a fundamental but not sufficient role; smoking is an independent predictor of ILD, and a correlation with the presence of rheumatoid factor and anti-cyclic citrullinated peptide antibodies has also been reported. Moreover, both exnovo occurrence and progression of ILD have been related to drug therapies that are commonly prescribed in RA, such as methotrexate, leflunomide, anti-TNF alpha agents, and rituximab. A greater understanding of the disease process is necessary in order to improve the therapeutic approach to ILD and RA itself and to reduce the burden of this severe extra-articular manifestation.

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Section: Differential Diagnosismentioning

confidence: 99%

The Multifaceted Aspects of Interstitial Lung Disease in Rheumatoid Arthritis

Cavagna

Monti

Grosso

et al. 2013

BioMed Research International

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“… 2 , 5 – 10 In these patients, the clinical picture may evolve during follow-up. 6 Furthermore, ASSD is characterized by a large heterogeneity in the severity of clinical findings, 5 , 11 , 12 in particular, for joint involvement, ranging from simple polyarthralgias, 5 to a symmetrical polyarthritis, 6 and that may be also seropositive, 13 , 14 for both Ig-M rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (ACPA).…”

Section: Introductionmentioning

confidence: 99%

Clinical Spectrum Time Course in Anti Jo-1 Positive Antisynthetase Syndrome

et al. 2015

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Anti Jo-1 antibodies are the main markers of the antisynthetase syndrome (ASSD), an autoimmune disease clinically characterized by the occurrence of arthritis, myositis, and interstitial lung disease (ILD). These manifestations usually co-occur (for practical purpose complete forms) in the same patient, but cases with only 1 or 2 of these findings (for practical purpose incomplete forms) have been described. In incomplete forms, the ex novo occurrence of further manifestations is possible, although with frequencies and timing not still defined. The aim of this international, multicenter, retrospective study was to characterize the clinical time course of anti Jo-1 positive ASSD in a large cohort of patients. Included patients should be anti Jo-1 positive and with at least 1 feature between arthritis, myositis, and ILD. We evaluated the differences between complete and incomplete forms, timing of clinical picture appearance and analyzed factors predicting the appearance of further manifestations in incomplete ASSD. Finally, we collected 225 patients (58 males and 167 females) with a median follow-up of 80 months. At the onset, complete ASSD were 44 and incomplete 181. Patients with incomplete ASSD had frequently only 1 of the classic triad findings (110 cases), in particular, isolated arthritis in 54 cases, isolated myositis in 28 cases, and isolated ILD in 28 cases. At the end of follow-up, complete ASSD were 113, incomplete 112. Only 5 patients had an isolated arthritis, only 5 an isolated myositis, and 15 an isolated ILD. During the follow-up, 108 patients with incomplete forms developed further manifestations. Single main feature onset was the main risk factor for the ex novo appearance of further manifestation. ILD was the prevalent ex novo manifestation (74 cases). In conclusion, ASSD is a condition that should be carefully considered in all patients presenting with arthritis, myositis, and ILD, even when isolated. The ex novo appearance of further manifestations in patients with incomplete forms is common, thus indicating the need for an adequate clinical and instrumental follow-up. Furthermore, the study clearly suggested that in ASSD multidisciplinary approach involving Rheumatology, Neurology, Pneumology, and Internal Medicine specialists is mandatory.

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“…Taken together, these data confirm that in anti-Jo-1-positive antisynthetase syndrome, several therapeutic options should be taken into account in order to reduce the burden of the disease. By considering the peculiarity of ILD in antisynthetase syndrome, as suggested by a proteomic study (7) and the wide range of clinical manifestations described in this setting (8,9), further controlled studies are warranted to establish the optimal treatment in these patients. We compliment Gossec and colleagues for their strong article published recently in Arthritis Care & Research (1).…”

Section: To the Editormentioning

confidence: 99%

“…According to the Third National Health and Nutrition Examination Survey data set, 41% of women and 68% of men ages Ͼ50 years have normal bone density (7). In this population, the benefits of bisphosphonates are unclear, so we may be causing more harm than good because of the side effects of bisphosphonates, including the small risk of atypical femur fractures (8). The 2007 European League Against Rheumatism guidelines are less specific and recommend individualizing decisions about bisphosphonate use based on risk factors and BMD (9).…”

Section: To the Editormentioning

confidence: 99%