Background/Purpose: Autoantibody positivity, erosions, activity level, and functional capacity were classically defined as poor prognosis. Paradoxically, many of them also predict a good response to treatment. Objective: To estimate the proportion of patients achieving remission and low activity by CDAI and SDAI per year in a cohort of patients with RA. To assess the impact of basal ACPA titers and total cholesterol level on response to treatment.

Methods: An observational study, where patients older than 18 who entered the Reumacheck program were included, in the first visit it was carried out: laboratory (including ACPA and total cholesterol: CT), Rx, ultrasound, and interview where were collected sociodemographic data (age, sex, schooling, occupation, toxic habits), clinical data (time of evolution, comorbidities, family history) and CDAI, SDAI, HAQ; each evaluator did not know the data from the other studies and evaluations, ACPA levels were measured in titles and divided into quartiles (Q1: 0-5, Q2: 5-50, Q3:50 -200, Q4: > 200). Those who were diagnosed with RA one year underwent a new control (FR and ACPA) where the same laboratory, clinical and treatment data were collected, and CDAI and SDAI remission and low activity (LDA) were calculated. Statistical analysis: descriptive statistics, Chi2 test and Fisher’s exact test were performed. T-test of student and Mann Whitney. Multiple logistic regression. ROC curve analysis to estimate cutoff values for cholesterol.

Results: Of the 183 patients diagnosed with RA between 2018-19, 83 performed a new check-up per year. The baseline characteristics are in Table 1. They achieved CDAI – SDAI remission at one year, CDAI-SDAI LDA (%): 21, 22.4, 55.3, 55 respectively. Reaching CDAI LDA (≤ 10) was associated at baseline to: ACPA (yes-no) 64.4% p 0.05 RR 2.5 (1.02-6.4), ACPA quartile 3-4 76.5% p 0.016 RR 3.3 (1.2-11.5), ACPA title 79.5 vs. 3.95 p 0.04, initiation of anti TNF 66% p 0.04 RR 2.6 (1.3-6 ), CT levels 185 vs 207 p 0.04, HAQ 0.5 vs 0.8 p 0.047 and swollen joints 1 (0-3) vs 2 (0-6) p 0.05. CDAI remission (≤ 2.8) was associated only with lower baseline total cholesterol levels: 170 (38) vs. 202 (47) p 0.025.

Reaching SDAI LDA (≤ 11) was associated at baseline to: ACPA (yes-no) 69% p 0.05 RR 2.5 (1.01-6.4), ACPA quartile 3-4 76% p 0.016 RR 3 , 3 (1,2-11), ACPA titer 80 vs 3.45 p 0.047, initiation of anti TNF 66.7% p 0.04 RR 2.6 (1.2-6), levels CT 184 vs 206 p 0.04, HAQ 0.5 vs 0.78 p 0.047 and swollen joints 1 (0-3) vs 2 (0-6) p 0.05. SDAI remission (≤ 3.3) was associated only with lower baseline total cholesterol levels: 168 (36) vs. 203 (47) p 0.025. Two logistic regression models were made, where the predictor variables, sex, age, dyslipidemia, use of statins and treatment were included: both for CDAI and SDAI LDA was independently associated with ACPA quartile 3-4 p 0.02 expB 3 and high cholesterol p 0.016 expB 0.21. In the ROC curve analysis, the best cut-off value was estimated for the baseline CT level predicted by CDAI LDA: AUC 0.67 (0.54-0.8): value 180 (S: 70% E: 50%) for both.

Conclusion: Patients with RA at one-year follow-up reached CDAI – SDAI remission, CDAI-SDAI LDA (%): 21, 22.4, 55.3, 55 respectively. High ACPA titers and low cholesterol levels were associated with achieving remission and LDA by these methods.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/acpa-and-cholesterol-titers-as-predictors-of-good-clinical-response-at-one-year-in-an-argentine-cohort/