Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Rheumatoid arthritis (RA) is a chronic inflammatory disease leading to joint destruction. Serologically, it can be differentiated according to rheumatoid factor (RF), anti-cyclic-citrullinated-peptide antibodies (anti-CCP) or both. This differentiation is prognostically and therapeutically relevant. No method has been described to separate the two forms phenotypically. We hypothesize that a differentiation is possible by evaluating oscillation patterns in power Doppler sonography (PDS).
Methods: In a prospective study, 20 patients with anti-CCP-positive RA and 20 patients with anti-CCP-negative RA with active wrist synovitis were examined. A PDS scan was performed, and perfusion maxima (Pmax) and minima (Pmin) as well as the difference (ΔP) were determined by a blinded study member. The difference was standardized (sΔP) by dividing by Pmax, and the anti-CCP-positive and -negative patients as well as the RF-positive and -negative were compared to each other.
Results: In the ultrasonographic evaluation we found a highly significant difference in sΔP between anti-CCP positive and anti-CCP negative patients (Median 19.01% vs. 42.92%, p<0.0001) (Fig.1). sΔP is independent of disease activity. ΔP did not differ between the groups. Also, in anti-CCP-positive patients there was a completely linear correlation between Pmax and Pmin, this was far less marked in anti-CCP-negative patients (Fig.2). The difference between RF positive and RF negative patients was significant, but less pronounced than for anti-CCP.
Conclusion: Anti-CCP-positive and anti-CCP-negative RA display different PDS oscillation patterns. This constitutes a non-serological parameter to differentiate between the two forms. The difference in PDS oscillation patterns suggests that the underlying pathological process differs between the forms.
To cite this abstract in AMA style:Gadeholt O, Wech T, Schuh S, Scharbatke EC, Niederle E, Tony HP, Schmalzing M. Anti-CCP Status Determines the Power Doppler Oscillation Pattern in Rheumatoid Arthritis – a Prospective Study [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/anti-ccp-status-determines-the-power-doppler-oscillation-pattern-in-rheumatoid-arthritis-a-prospective-study/. Accessed December 1, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/anti-ccp-status-determines-the-power-doppler-oscillation-pattern-in-rheumatoid-arthritis-a-prospective-study/