The effect of etanercept on anti-cyclic citrullinated peptide antibodies and rheumatoid factor in patients with rheumatoid arthritis

Chen, Horng-An; Lin, Kuan‐Chia; Chen, Chun-Hsiung; Liao, Hsien‐Tzung; Wang, Hon-Pin; Chang, Hsiao-Ning; Tsai, Chang‐Youh; Chou, Chen‐Te

doi:10.1136/ard.2005.038851

Cited by 103 publications

(61 citation statements)

References 30 publications

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“…Bobbio-Pallavicini et al (36 ) reported a significant decrease in anti-CCP antibody titer at 30 weeks during infliximab and methotrexate therapy, but titers returned to baseline thereafter. Chen et al (37 ) found a significant decrease of anti-CCP serum concentrations after 3 months of etanercept treatment. Mikuls et al (38 ) reported a significant decrease of anti-CCP titers over the follow-up period among RA patients of whom a majority received active therapy with disease-modifying antirheumatic drugs.…”

Section: Discussionmentioning

confidence: 99%

Technical and Diagnostic Performance of 6 Assays for the Measurement of Citrullinated Protein/Peptide Antibodies in the Diagnosis of Rheumatoid Arthritis

Coenen

Verschueren²,

Westhovens³

et al. 2007

Clinical Chemistry

153

113

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Background: Several anticitrullinated protein/peptide antibodies (ACPA) assays have been reported to be of diagnostic value for rheumatoid arthritis (RA). We evaluated the technical performance and diagnostic accuracy of 6 ELISAs for the detection of antibodies to citrullinated protein/peptide antigens. Methods: ACPA were determined in 298 serum samples using 6 commercially available ACPA assays. One hundred two samples were from RA patients, including patients with early and established RA, and 196 were from controls, including patients with psoriatic arthritis, connective tissue diseases, organ-specific autoimmune diseases, and a group of consecutive patients for whom a rheumatologist ordered anticyclic citrullinated peptide (CCP) antibodies. The ELISA reagent sets under study were Citrullinated Protein Antibodies (Genesis), Anti-MCV (Orgentec), Immunoscan RA (Euro-Diagnostica), Anti-CCP IgG ELISA (Euroimmun), EliA™ CCP (Phadia), and Quanta Lite™ CCP3 IgG ELISA (Inova). Technical performance (imprecision, linearity, correlation, and agreement) and diagnostic accuracy (sensitivity and specificity) were compared. Results: Variable technical performance was noted among the different ACPA assays, with some assays displaying poor reproducibility and bad linearity. ACPA results were well correlated among assays with the same antigen specificity, but the numerical values reported for each assay differed widely. Using cutoff values proposed by the manufacturer, diagnostic sensi-

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Section: Discussionmentioning

confidence: 99%

Technical and Diagnostic Performance of 6 Assays for the Measurement of Citrullinated Protein/Peptide Antibodies in the Diagnosis of Rheumatoid Arthritis

Coenen

Verschueren²,

Westhovens³

et al. 2007

Clinical Chemistry

153

113

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“…This might be due to treatment. Some studies documented that the level of the RF decreases with treatment [23,24]. The current study showed that RF was also positive in 13 patients with non-RA rheumatic diseases.…”

Section: Rfmentioning

confidence: 49%

A Comparative Assessment of the Diagnostic Value of Anti-cyclic Citrullinated Peptide Antibodies and Rheumatoid Factor in Rheumatoid Arthritis

Binesh¹

2014

J Clin Exp Pathol

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Rheumatoid arthritis is a systemic, chronic inflammatory autoimmune disease affecting many tissues but principally attacking the joints. Auto antibodies such as rheumatoid factor and anti-cyclic Citrullinated peptide antibodies have important diagnostic value. This cross-sectional analytical study was performed at a single medical institution in central Iran (Shahid Sadoughi Hospital, Yazd, Iran) in order to compare the diagnostic value of anti-cyclic citrullinated peptide antibodies and rheumatoid factor in patients with rheumatoid arthritis. Serum levels of anti-cyclic citrullinated peptide antibodies were determined by enzyme-linked immunosorbent assay, and levels of rheumatoid factor were determined by turbidimetry on a latex-enhanced agglutination assay in 266 patients with rheumatoid arthritis and 134 patients with non-rheumatoid arthritis rheumatic diseases.Among the 266 patients with rheumatoid arthritis, 188 patients (70.7%) were tested positive for anti-cyclic citrullinated peptide antibodies, and 123 patients (46.2%) were tested positive for rheumatoid factor. The sensitivity, specificity, positive predictive value and negative predictive value of anti-cyclic citrullinated peptide antibodies for diagnosing rheumatoid arthritis were 70.76%, 85.07%, 90%, and 59% respectively. Those for rheumatoid factor were 46.26%, 90.29%, 90%, and 45% respectively. The anti-cyclic Citrullinated peptide antibodies measurement is a useful test for diagnosing rheumatoid arthritis. Due to its high positive predictive value and negative predictive value, it is an important diagnostic test and gives accurate diagnosis of the disease. However, this does not mean that anti-cyclic citrullinated peptide antibodies can replace rheumatoid factor in the diagnosis of rheumatoid arthritis, because not all rheumatoid arthritis patients have anti-cyclic Citrullinated peptide antibodies. The two tests therefore appear to be complementary.

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“…1). Among these biological therapies, B cell depletion [33] and neutralization of TNF-a [38][39][40][41][42][43][44][45][46][47][48][49] and IL-6 [50,51] have been studied most successfully for their effects on ACPA levels and B cell populations. There are some limited data on the effects of oral disease-modifying anti-rheumatic drugs (DMARDs) on ACPA levels [38] and very few data on the effects of CTLA-4-Ig and IL-17 neutralization on ACPA levels, although there is good reason to believe that T cell co-stimulation and IL-17 also regulate ACPA levels.…”

Section: The Effect Of Targeted Ra Therapies On Acpa Levels and B Celmentioning

confidence: 99%

“…Although TNF antagonists reduce RF levels [39][40][41][42][43][44][45][46][47][48][49], these same studies have not established conclusively whether oral DMARDs and/or TNF-antagonists reduce anti-CCP levels. As summarized in Table 2, some studies have identified reductions in anti-CCP levels with TNF-antagonist therapy [38,39,[43][44][45][46]48], while others have seen no effect of TNF-antagonists on anti-CCP levels [40][41][42]47,49]. In some of these studies TNF-antagonist therapy was compared to oral DMARD therapy [43,45]; TNF antagonists, but not oral DMARDs, decreased anti- CCP levels, although in these studies subjects receiving only oral DMARDs did not have as great a reduction in disease activity.…”

Section: Tnf-a Blockadementioning

confidence: 99%

The effect of targeted rheumatoid arthritis therapies on anti-citrullinated protein autoantibody levels and B cell responses

Modi

Soejima

Levesque

2013

Clinical and Experimental Immunology

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SummaryRheumatoid arthritis (RA) is a complex inflammatory disorder associated with synovitis and joint destruction that affects an estimated 1·3 million Americans and causes significant morbidity, a reduced life-span and lost work productivity. The use of biological therapies for the treatment of RA is costly, and the selection of therapies is still largely empirical and not guided by the underlying biological features of the disease in individual patients. The synovitis associated with RA is characterized by an influx of B and T cells, macrophages and neutrophils and the expansion of fibroblast-like synoviocytes, which form pannus and lead to cartilage and bone destruction. RA is associated with synovial production of rheumatoid factor (RF) and anticitrullinated protein autoantibodies (ACPA) and with the production of inflammatory cytokines, including interleukin (IL)-1, IL-6, IL-17 and tumour necrosis factor (TNF)-a, which are targets for RA therapeutics. Recent ideas about the pathogenesis of RA emphasize a genetic predisposition to develop RA, a preclinical phase of disease that is associated with the production of ACPA and the development of symptomatic disease following inflammatory initiating events that are associated with expression of citrullinated epitopes in the joints of patients. However, we still have a limited understanding of the cytokine and intracellular pathways that regulate ACPA levels. In humans, therapy with biological agents affords a unique opportunity to better understand the cytokine and signalling pathways regulating ACPA levels and the impact of ACPA level changes on disease activity. In this study we summarize the effect of RA therapies on ACPA levels and B cell responses.

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The effect of etanercept on anti-cyclic citrullinated peptide antibodies and rheumatoid factor in patients with rheumatoid arthritis

Cited by 103 publications

References 30 publications

Technical and Diagnostic Performance of 6 Assays for the Measurement of Citrullinated Protein/Peptide Antibodies in the Diagnosis of Rheumatoid Arthritis

Technical and Diagnostic Performance of 6 Assays for the Measurement of Citrullinated Protein/Peptide Antibodies in the Diagnosis of Rheumatoid Arthritis

A Comparative Assessment of the Diagnostic Value of Anti-cyclic Citrullinated Peptide Antibodies and Rheumatoid Factor in Rheumatoid Arthritis

The effect of targeted rheumatoid arthritis therapies on anti-citrullinated protein autoantibody levels and B cell responses

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