ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1560

Clinical Characterization Of Anti-CCP+Ve Systemic Lupus Erythematosus Patients

Samera Vaseer1,2 and Eliza Chakravarty3, 1Rheumatology, University Of Oklahoma, Oklahoma City, OK, 2Oklahoma Medical Research Foundation, Oklahoma City, OK, 3Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Systemic Lupus Erythematosus - Clinical Aspects II: Central Nervous System Manifestations, Therapeutics

Session Type: Abstract Submissions (ACR)

Background/Purpose:

SLE is a heterogeneous autoimmune disease characterized by the presence of autoantibodies and manifestations of numerous organ systems. One of the most common SLE manifestations is inflammatory arthritis, often indistinguishable from rheumatoid arthritis in early stages when other manifestations are not present. Antibodies directed against citrullinated peptides (anti-CCP) were initially thought to be highly specific for RA (specificity estimated at 98%). The prevalence and role of anti-CCP antibodies has not been well characterized in SLE patients.   

The purpose of this study is to estimate the prevalence of anti-CCP antibodies among SLE patients and to identify unique characteristics of CCP+ve SLE patients in comparison to CCP     -ve SLE patients in a case control fashion.

Methods:

The Oklahoma Lupus Cohort is a prospective longitudinal observational cohort. Participants provide written informed consent to participate, and have clinical data as well as peripheral blood specimens collected during routine clinical care. Serologies are obtained on all participants. 

SLE patients with positive anti-CCP antibodies were identified and their demographic, clinical, and serological characteristics were compiled through chart review. In order to identify features that are unique to CCP+ SLE, we identified 2-3 controls, CCP- SLE patients matched for age and gender, to each CCP+ case

Results:

Of the total 227 SLE patients with known CCP serologies, 26 (11.5%) were found to be anti-CCP positive (>20 IU). Mean anti-CCP value was 90. Cases were separated into high positive anti CCP group (>60) and low to moderate positive anti-CCP group (<60).  60% were current or former smokers in the high positive group. Ethnic distribution was as follows; Caucasian 60%, African American10%,  Native American 20%, and 10% Hispanic. 

Majority of CCP+ SLE patients had clinical features similar to CCP negative group with high frequency of sicca symptoms 80% vs. 49% in controls.  Inflammatory arthritis, Raynauds, cutaneous manifestations and mucosal ulcers were also frequent, though similar to the control group.  The prevalence of renal disease and CNS disease in the CCP+ SLE patients was similar to that reported in the literature.

Aside from ANA, the most prevalent autoantibodies among CCP+SLE patients were anti-Ro/SSA (50%), and RNP (40%). RF was seen in 40% of high CCP+ group compared to 15% in control group

Conclusion:

Anti CCP positive SLE subjects have a high frequency of arthritis and sicca symptoms.  CCP+SLE patients share many common SLE autoantibodies with CCP- patients with high prevalence of anti Ro, RNP and RF among this group.

Disclosure:

S. Vaseer,
None;

E. Chakravarty,
None.

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