Background/Purpose: To evaluate anti-cyclic citrullinated protein antibody positivity in the general population and to identify its prognosis.

Methods: Anti-cyclic citrullinated protein antibody (ACPA) were measured with immunochromatographic test in 3607 people who visited for routine annual medical check-up from November 2014 to March 2016. Four people with history of rheumatic diseases except for rheumatoid arthritis (RA) were excluded from analysis. For ACPA positive persons, consultation to rheumatology was recommended. They were examined ACPA with CLEIA method, anti-nuclear antibody test, and anti SS-A antibody test. Also rheumatologist performed detail physical examination. The classification criteria of 2010 ACR/EULAR were used for diagnosis of RA. Asymptomatic examinees with ACPA positive were recommended to visit every 6 months. Symptomatic examinees that did not fulfill classification criteria even if they have morning stiffness or joint pain were recommended to visit every 3 months. While follow-up period, an examinee that fulfills classification criteria was prescribed DMARDs in accordance with guidelines.

Results: ACPA positivity with immunochromatographic test was identified in 1.0% (n=37) of examinees. 51.4% were woman. There were no correlations between ACPA positivity and smoking, drinking, BMI, and history of cancer. Among ACPA positive examinees, 64%(n=24) consulted to rheumatology department. They were confirmed ACPA positivity with CLEIA method. 58.3% (n=14) were CLEIA method positive. 57.1% were woman. 4 examinees have already diagnosed as RA and 5 examinees have morning stiffness or joint pain, which did not fulfill classification criteria. Mean follow-up period of ACPA positive examinees with CLEIA and immunochromatographic method was 10.5 month. One of 5 symptomatic patients developed RA and she reached remission after 2 months after starting methotrexate.

Conclusion: Positivity of ACPA in general population was 1%. Regular follow-up of ACPA positive patients could lead prompt diagnosis and treatment.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/anti-cyclic-citrullinated-protein-antibody-acpa-positivity-in-general-population-and-follow-up-results-for-acpa-positive-persons/