Is ACPA-Positive RA Still a More Severe Disease Than ACPA-Negative RA? a Longitudinal Cohort Study in RA-Patients Treated from 2000 Onwards

Aleid C. Boer¹, Annelies Boonen² and Annette H.M. van der Helm-van Mil³, ¹Rheumatology, Leiden University Medical Center, Leiden, Netherlands, ²Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre+, Maastricht, The Netherlands, Maastricht, Netherlands, ³Department of Rheumatology, Leiden University Medical Center, Leiden, Netherlands

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: ACPA, Early Rheumatoid Arthritis, Outcome measures, patient outcomes and rheumatoid arthritis (RA)

Session Information

Date: Monday, November 6, 2017

Title: Rheumatoid Arthritis – Clinical Aspects Poster II: Pathophysiology, Autoantibodies, and Disease Activity Measures

Session Type: ACR Poster Session B

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

Background/Purpose:

Anti-citrullinated-protein antibodies (ACPA)-positive rheumatoid arthritis (RA) is considered as more severe than ACPA-negative RA, because of its association with joint destruction. Clinically relevant joint destruction is now infrequent, thanks to adequate disease suppression. According to patients, important outcomes are pain, fatigue and independence. We evaluated if ACPA-positive RA-patients diagnosed ≥2000 have more severe self-reported limitations and impairments including restrictions at work than ACPA-negative RA-patients.

Methods:

492 ACPA-positive, 450 ACPA-negative 2010-criteria-positive RA-patients included in the Leiden Early Arthritis Clinic cohort ≥2000 were compared for self-reported pain, fatigue, disease activity, general wellbeing (measured by numerical rating scales) and physical function (measured by the health assessment questionnaire, HAQ) and also work restrictions including absenteeism at baseline and during 4-year follow-up. Linear mixed models were used.

Results:

At disease presentation, ACPA-negative patients had more severe pain, fatigue, self-reported disease activity-scores and functional disability (p<0.05), although absolute differences were small. During follow-up ACPA-negative patients remained somewhat more fatigued (p=0.002), whereas other patient-reported impairments and limitations were similar. 38% ACPA-negative and 48% ACPA-positive patients reported absenteeism (p=0.30), with median 4 days missed in both groups in the last 3 months. Also restrictions at work among employed patients and restrictions with household work were not statistically different at baseline and during follow-up.

Conclusion:

In current rheumatology practice, ACPA-positive RA is not more severe than ACPA-negative RA in terms of for patients relevant outcomes including physical functioning and restrictions at work. This implies that effort to further improve the disease course should not restrict to ACPA-positive patients.

Disclosure: A. C. Boer, None; A. Boonen, None; A. H. M. van der Helm-van Mil, None.

To cite this abstract in AMA style:

Boer AC, Boonen A, van der Helm-van Mil AHM. Is ACPA-Positive RA Still a More Severe Disease Than ACPA-Negative RA? a Longitudinal Cohort Study in RA-Patients Treated from 2000 Onwards [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/is-acpa-positive-ra-still-a-more-severe-disease-than-acpa-negative-ra-a-longitudinal-cohort-study-in-ra-patients-treated-from-2000-onwards/. Accessed .

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