Self-limiting arthritis among patients fulfilling the 2010 ACR/EULAR classification criteria for rheumatoid arthritis in a very early arthritis cohort

Norli, Ellen Sauar; Brinkmann, Gina Hetland; Kvien, Tore K; Bjørneboe, Olav; Haugen, Anne Julsrud; Nygaard, Halvor; Thunem, Cathrine; Lie, Elisabeth; Mjaavatten, Maria D

doi:10.1016/j.semarthrit.2016.07.004

Cited by 9 publications

(7 citation statements)

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“…Although we cannot exclude RA over-diagnosis according to the 2010 criteria [ 34 ], differential diagnoses were carefully evaluated and applying the 1987 criteria did not affect the results. The frequency of autoantibodies was lower than expected [ 35 – 37 ], but still comparable with other early arthritis cohorts from similar geographical areas [ 38 ], including the Etude et Suivi des POlyarthrites Indifférenciées Récentes (ESPOIR) cohort, in which 46–49 % of the patients fulfilling the RA classification criteria at inclusion are reported as ACPA-positive [ 39 – 41 ]. Irrespective of the prevalence of autoantibodies, however, we believe that the observed differences in BMD according to autoantibody levels clearly confirm the specific association between RA autoimmunity and systemic bone loss.…”

Section: Discussionsupporting

confidence: 74%

Anti-citrullinated protein antibodies and high levels of rheumatoid factor are associated with systemic bone loss in patients with early untreated rheumatoid arthritis

et al. 2016

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BackgroundAutoantibodies such as anti-citrullinated protein antibodies (ACPA) are major risk factors for articular bone destruction from the earliest phases of rheumatoid arthritis (RA). The aim of the current study was to determine whether RA-associated autoantibodies also impact on systemic bone loss in patients with early disease.MethodsSystemic bone mineral density (BMD) was measured in the lumbar spine and the hip in 155 consecutive treatment-naïve patients with early RA (median symptom duration 13 weeks). Demographic and disease-specific parameters, including clinical disease activity, ultrasonographic (US) examination of the hands and wrists, radiographic scoring of joint damage, ACPA and rheumatoid factor (RF) levels were recorded from all patients. Reduced BMD was defined as Z score ≤ -1 SD and analysed in relation to disease-related characteristics and autoantibody subgroups.ResultsReduced BMD was found in 25.5 % of the patients in the spine and 19.4 % in the hip. Symptom duration, clinical and US disease activity, functional disability and radiographic damage did not significantly impact on spine and hip BMD loss in regression analyses adjusted for possible confounders (age, gender, menopausal status, current smoking, body mass index). In contrast, ACPA positivity (at any level) negatively affected the spine Z-score (adjusted OR (95 % CI) 2.76 (1.19 to 6.42)); the hip Z score was affected by high titres only (adjusted OR (95 % CI) 2.96 (1.15 to 7.66)). The association of ACPA with reduced BMD in the spine was confirmed even at low levels of RF (adjusted OR (95 % CI) 2.65 (1.01 to 7.24)), but was further increased by concomitant high RF (adjusted OR (95 % CI) 3.38 (1.11 to 10.34)). In contrast, Z scores in the hip were significantly reduced only in association with high ACPA and RF (adjusted OR (95 % CI) 4.96 (1.48 to 16.64)).ConclusionsSystemic BMD in patients with early RA is reduced in relation with ACPA positivity and high RF levels. This finding supports the notion that RA-associated autoimmunity may have a direct causative role in bone remodeling.

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Section: Discussionsupporting

confidence: 74%

Anti-citrullinated protein antibodies and high levels of rheumatoid factor are associated with systemic bone loss in patients with early untreated rheumatoid arthritis

et al. 2016

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“…Among the 26 patients who fulfilled the 2010 ACR/EULAR Criteria for RA during follow‐up, 84.6% developed CIRD. This finding is in line with data from the entire NOR‐VEAC cohort, as well as with validation studies of the criteria in early arthritis populations with more joints affected . Use of the criteria facilitated earlier recognition of RA among seropositive patients.…”

Section: Discussionsupporting

confidence: 83%

Joint Distribution and Two‐Year Outcome in 347 Patients With Monoarthritis of Less Than Sixteen Weeks’ Duration

Norli

Brinkmann

Kvien

et al. 2020

Arthritis Care & Research

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Approximately one-fourth of patients with recent-onset monoarthritis developed CIRD over 2 years. Patients presenting with ankle arthritis rarely developed CIRD, whereas patients presenting with wrist arthritis more frequently did so. Longer duration of joint swelling and ACPA- and RF positivity were also predictive of CIRD. Our findings facilitate early identification of monoarthritis patients with unfavorable prognosis. This article is protected by copyright. All rights reserved.

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“…These antibodies are not only important for early diagnosis of RA, but also in predicting the prognosis, which are indications for intensive treatment. In contrast, negative ACPA status, short symptom duration and being a non‐smoker are factors associated with self‐limiting arthritis in early arthritis patients . A prospective cohort study revealed Health Assessment Questionnaire score, ACPA, body mass index, 6‐month cumulative erythrocyte sedimentation rate, and baseline Sharp/Van der Heijde modified score (SHS) as predictors of severe radiographic progression in patients with early RA …”

Section: Precision Medicine In Ramentioning

confidence: 99%

The challenges of early diagnosis and therapeutic prediction in rheumatoid arthritis

Zhao

2018

Int J of Rheum Dis

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Self-limiting arthritis among patients fulfilling the 2010 ACR/EULAR classification criteria for rheumatoid arthritis in a very early arthritis cohort

Cited by 9 publications

References 25 publications

Anti-citrullinated protein antibodies and high levels of rheumatoid factor are associated with systemic bone loss in patients with early untreated rheumatoid arthritis

Anti-citrullinated protein antibodies and high levels of rheumatoid factor are associated with systemic bone loss in patients with early untreated rheumatoid arthritis

Joint Distribution and Two‐Year Outcome in 347 Patients With Monoarthritis of Less Than Sixteen Weeks’ Duration

The challenges of early diagnosis and therapeutic prediction in rheumatoid arthritis

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