Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Serum anti-cyclic citrullinated peptide antibodies (anti-CCP2) positivity was associated with presence of interstitial lung disease and airway disease in rheumatoid arthritis (RA). This study analyze whether high resolutional CT (HRCT) and anti-CCP2 can predict the outcome of ILD in RA.
Methods: 472(Male74/Female398, age 58.9+/-14.0) cases were analyzed in this study. Participants met 2010 ACR/EULAR classification criteria of RA were followed up at least one year as newly onset RA. All patients were also performed chest radiological examinations at the initial presentation. ILD extension Score was determined based on the presence and extent of ILD features (i.e., ground glass opacification (GGO), reticulation and honeycombing (HC) using a semiquantitative scale at the each of the three zones of each lung with a maximum total score possible of 6. HRCT parameters which include ILD extension Score and titer of anti-CCP2 at the initial presentation were retrospectively analyzed.
Results: 231 out of 472 patients (48.9%) had abnormal chest radiological findings which included bronchiectasis, bronchitis and ILD. 101 out of 472 patients (21.4%) showed ILD at initial presentation. The titer of anti-CCP2 showed statistical difference between RA only vs. RA-ILD patients( Ave. 47.8 and 164.3 U/ml, respectively, p<0.001). 6 out of 101 RA-ILD patients showed rapidly progressive ILD. These 6 patients had widely spread honeycombing compared to asymptomatic RA-ILD patients (p=0.0012). In 101 RA-ILD patients, higher anti-CCP2 levels were associated with more severe RA-ILD. Average titer of anti-CCP2 in ILD extension Score 1, 2, 3, 4, 6 showed 20.3+/-28.4, 155.0+/-49.6, 290.9+/-26.3, 693.7+/-308.9 and 1582.5+/-120.9 U/ml respectively. Higher extension score of each ILD features GGO (p=0.0052), reticulation (p=0.0047) and honeycombing (p=0.0025) also showed association with higher anti-CCP2.
Conclusion: Anti-CCP2 antibodies are marker of severity and extent of RA-ILD in HRCT. HRCT findings focused on ILD extension Score at the initial presentation is a useful predictor of the outcome of ILD in RA. Anti-CCP2 is one of the related factor of ILD extension Score.
To cite this abstract in AMA style:Yamasaki M. Anti-Cyclic Citrullinated Peptide Antibodies and Severity of Interstitial Lung Disease with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/anti-cyclic-citrullinated-peptide-antibodies-and-severity-of-interstitial-lung-disease-with-rheumatoid-arthritis/. Accessed July 7, 2020.
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