ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 496

Impact of Anti-Citrullinated Protein Antibody and/or Rheumatoid Factor on Rheumatoid Arthritis Manifestations and Outcomes

Ee Tzun Koh1, Angela Marie Chan1, Wei Qiang See2, Wenwei Xiang2, Khai Pang Leong1 and Tan Tock Seng Rheumatoid Arthritis Study Group, 1Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore, 2Clinical Research and Innovation Office, Tan Tock Seng Hospital, Singapore, Singapore

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: , ,

Session Information

Date: Sunday, November 13, 2016

Title: Rheumatoid Arthritis – Clinical Aspects - Poster I: Clinical Characteristics/Presentation/Prognosis

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: RA Patients with anti-citrullinated protein antibody (ACPA) or rheumatoid factor (RF) are known to have worse clinical outcomes compared to seronegative patients. To determine if there were differences in clinical, laboratory features and outcomes of RA patients based on their ACPA and RF status (group I: ACPA+RF+, II: ACPA+RF -, III: ACPA -RF+, IV: ACPA-RF-). All patients fulfilled the 1987 ACR criteria for RA.

Methods: ACPA and RF titres were analysed by ELISA. Statistical analysis was conducted using STATA 13.0 (College Station, TX). We used Chi-square test or Fisher’s exact test to compare categorical variables. We used ANOVA or Kruskal Wallis test for continuous variables, followed by posthoc Tukey’s HSD test when appropriate. A two tailed significance level of 0.05 was chosen for all tests.

Results: The study population comprises 970 patients (group I 663, II 68, III 106, IV 133) with mean disease duration of 174.4 + 103.4 months. The gender distribution, educational level, smoking status, mean disease duration, age of onset, age at RA diagnosis, duration from onset to 1st DMARD and number of co-morbidities were similar among the 4 groups. At presentation, group I had significantly higher ESR (mean 59.9mm/hr vs 48.5-55.8mm/hr in the other 3 groups, p = 0.005). Group I patients were more likely to have deformed joints (65.3 % vs 42.1-65.2 % in other groups, p<0.001) despite higher usage of prednisolone (59.3 % vs 39.9-58.8 in other groups, p <0.001) and higher number of synthetic DMARDs (2.86 vs 2.31-2.74 in other groups, p< 0.001). Fewer patients in groups I & II (66.2% and 62.7% respectively) achieved remission (DAS 28 < 2.6) compared to those in groups III & IV (74.3 % and 78.2 % respectively, p=0.02). However, the HAQ and Short form 36 (SF 36) scores did not differ among the 4 groups.

Conclusion: ACPA+RF+ RA patients have higher baseline ESR and fewer achieve remission, despite higher use of synthetic DMARDs compared to ACPA-RF+ and ACPA-RF- patients. However, these differences did not affect their functional status or quality of life.

Disclosure: E. T. Koh, None; A. M. Chan, None; W. Q. See, None; W. Xiang, None; K. P. Leong, None.

To cite this abstract in AMA style:

Koh ET, Chan AM, See WQ, Xiang W, Leong KP. Impact of Anti-Citrullinated Protein Antibody and/or Rheumatoid Factor on Rheumatoid Arthritis Manifestations and Outcomes [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/impact-of-anti-citrullinated-protein-antibody-andor-rheumatoid-factor-on-rheumatoid-arthritis-manifestations-and-outcomes/. Accessed .

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