Prevalence and Predictive Value over 16 Years of Serum Rheumatoid Factor and Anti-Cyclic Citrullinated Peptide Antibodies in the General Population

Elena Generali¹, Natasa Isailovic¹, Maria De Santis¹, Angela Ceribelli¹, Fausto Alborghetti², Guido Colloredo³, Luisa Porrati², Torsten Matthias⁴, Alberto Zucchi², Giacomo Maria Guidelli¹, Marta Caprioli¹ and Carlo Selmi^1,5, ¹Rheumatology and Clinical Immunology, Humanitas Research Hospital, Rozzano (MI), Italy, ²Bergamo Local Health Authority (ASL), Bergamo, Italy, ³Division of Internal Medicine, San Pietro Hospital, Ponte San Pietro (BG), Italy, ⁴Aesku.Diagnostics, Wendelsheim, Germany, ⁵BIOMETRA Department, University of Milan, Milan, Italy

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: autoantibodies, population studies and rheumatoid arthritis (RA)

Session Information

Date: Tuesday, November 7, 2017

Title: Epidemiology and Public Health Poster III: Rheumatic Disease Risk and Outcomes

Session Type: ACR Poster Session C

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

Background/Purpose: The prevalence of Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies in the general population may vary widely, as RF is present in 0-5% and anti-CCP in 0-9% of healthy controls, but the clinical significance in the general population remains unclear. We determined the prevalence of RF and anti-CCP antibodies in a large sample of the general population and their predictive value over developing rheumatoid arthritis (RA) over 16 years.

Methods: We took advantage of a randomly selected sample of a general population study initiated in 1998 (Isola I, originally including 2,828 subjects; 53% women, age 43±13 years) from a well-defined Northern Italian area. Serum RF and anti-CCP were tested in recent years by ELISA on 2,690 samples and data collected in 2017 (Isola II: 50% women, age 58±13 years). Administrative databases were searched for RA diagnoses occurring between enrollment and May 31^st 2017. The risk ratio (RR) was calculated for incident RA cases between subjects exposed and not exposed to RF and anti-CCP antibodies.

Results: RF was positive in 276 (10.2%), while anti-CCP were found in 127 (4.7%) subjects, with the latter at medium-high titer (>30 U/mL) in 25 (0.9%) subjects. Twelve (0.4%) cases of RA were found over 16 years, of which 3 (25%) positive for RF and 5 (41.7%) positive for anti-CCP antibodies, mostly at medium-high titer (4/5, 80%). Only one (8.3%) case of RA was positive both for RF and anti-CCP antibodies. We observed two cases of Sjögren’s syndrome, both positive for RF, while one was positive also for anti-CCP. The risk ratio (RR) of developing RA over 16 years is 3.08 (95% confidence interval – CI – 0.82-11.56, p=0.07) for RF positive subjects and 20.13 (95% CI 5.09-79-52, p<0.001), for anti-CCP antibodies positive subjects, and it increases up to 67.46 (95%CI 16.36-253.98; p<0.001) for medium-high titer anti-CCP antibodies.

Conclusion: We report a high prevalence of RF and anti-CCP in the general population of a Northern Italian region, but only anti-CCP are associated with a significantly increased risk of RA over 16 years.

Disclosure: E. Generali, None; N. Isailovic, None; M. De Santis, None; A. Ceribelli, None; F. Alborghetti, None; G. Colloredo, None; L. Porrati, None; T. Matthias, Aesku Diagnostics, 3; A. Zucchi, None; G. M. Guidelli, None; M. Caprioli, None; C. Selmi, None.

To cite this abstract in AMA style:

Generali E, Isailovic N, De Santis M, Ceribelli A, Alborghetti F, Colloredo G, Porrati L, Matthias T, Zucchi A, Guidelli GM, Caprioli M, Selmi C. Prevalence and Predictive Value over 16 Years of Serum Rheumatoid Factor and Anti-Cyclic Citrullinated Peptide Antibodies in the General Population [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/prevalence-and-predictive-value-over-16-years-of-serum-rheumatoid-factor-and-anti-cyclic-citrullinated-peptide-antibodies-in-the-general-population/. Accessed .

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-and-predictive-value-over-16-years-of-serum-rheumatoid-factor-and-anti-cyclic-citrullinated-peptide-antibodies-in-the-general-population/