Very recent onset rheumatoid arthritis: clinical and serological patient characteristics associated with radiographic progression over the first years of disease

Abstract

Despite early treatment, substantial damage occurred in some patients and was associated with presence of strong 'constitutive' predictors such as anti-CCP and RF as well as presence of high long-term clinical disease activity as indicated by C-reactive protein (CRP), swollen joint counts and the absence of a good clinical response (assessed by the failure to achieve lasting low disease activity).

The presence of rheumatoid nodules at early rheumatoid arthritis diagnosis is a sign of extra-articular disease and predicts radiographic progression of joint destruction over 5 years

“…Consistent with the literature, radiographic damage occurs early in the disease course [42][43][44]. In the present study 69% of the RN-patients and 53% of the controls had radiological destructions (SHS) already within 12 months after their first symptoms (baseline X-ray).…”

Antibodies to citrullinated peptides are not associated with the rate of joint destruction in patients with a well-established diagnosis of rheumatoid arthritis

“…Some of them detected no prognostic properties for antibodies to citrullinated epitopes (5,22,23). On the other hand, most studies did observe an association of erosive disease with antibodies to citrullinated epitopes and/or rheumatoid factor (6,7,(11)(12)(13)(24)(25)(26). Possible reasons for the discrepancy observed in the literature include ethnic differences, distinct criteria for patient selection, diverse methodological protocols, and the presence of confounding variables such as therapeutic interventions.…”

“…The apparent discrepancy between the present findings and those of some previous studies is probably due to patient selection. Most of the literature studies included only patients with undifferentiated polyarthritis at baseline (8,12) or only patients with very early RA (22)(23)(24)(25)(26). It is expected that part of these patients eventually will present definite RA and part of them will turn out to have some other benign form of chronic polyarthritis.…”

“…Recent studies have demonstrated that antibodies to citrullinated epitopes are quite efficient in predicting the development of epiphysis erosions among patients with early undifferentiated polyarthritis (7,(11)(12)(13). This discriminative ability may be related to the diagnostic property of antibodies to citrullinated epitopes of differentiating patients with RA, an erosive disease, from patients with other forms of polyarthritis with a benign course.…”

The diagnostic utility of the anti-CCP antibody test is no better than rheumatoid factor in South Africans with early rheumatoid arthritis

“…Autoantibodies directed against citrulline, an amino acid that results from post-translational modification of arginine in inflamed synovial membranes, have been shown to have a high specificity of 93-98% in early RA [3]. These antibodies to cyclic-citrullinated peptide (aCCP) are also of prognostic value in predicting disease severity, erosive damage and response to therapy [4,5].…”