Anti-Peptidyl Arginine Deiminase 4 Antibodies in African-Americans with Rheumatoid Arthritis and Radiographic Scores

Iris Navarro-Millan¹, Andrew Westfall², Erika Darrah^3,4, Antony Rosen⁵, Ted R. Mikuls⁶, Richard Reynolds², Maria I. Danila⁷, Jeffrey R. Curtis² and S. Louis Bridges Jr.^2,8, ¹Rheumatology, University of Alabama at Birmingham, Birmingham, AL, ²University of Alabama at Birmingham, Birmingham, AL, ³Division of Rheumatology, The Johns Hopkins University, Baltimore, MD, ⁴5200 Eastern Ave MFL Bldg Cntr, The Johns Hopkins University, Division of Rheumatology, Baltimore, MD, ⁵Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, ⁶Veteran Affairs Nebraska Western Iowa Health Care System and University of Nebraska Medical Center, Omaha, NE, ⁷Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, ⁸Division of Clinical Immunology & Rheumatology, University of Alabama at Birmingham, Birmingham, AL

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: African-Americans, PAD, radiography and rheumatoid arthritis (RA)

Session Information

Title: Rheumatoid Arthritis - Human Etiology and Pathogenesis

Session Type: Abstract Submissions (ACR)

Background/Purpose: The presence of serum autoantibodies to peptidyl arginine deiminase 4 (PAD4) have been associated with erosive rheumatoid arthritis (RA) in populations that were composed of predominantly Caucasian patients with RA but their role has not been studied in African-Americans with RA. We sought to determine the prevalence of serum anti-PAD4 antibodies in African-Americans with RA and if there was an increase in radiographic scores among those patients with anti-PAD4 antibodies (+anti-PAD4) compared to those that were negative for anti-PAD4 (-anti-PAD4).

Methods: Patients with RA included in the study were 193 participants in the Consortium for the Longitudinal Evaluation of African Americans with Early Rheumatoid Arthritis (CLEAR) Registry I and II. For this analysis we combined patients with early RA (CLEAR I) and established RA (CLEAR II). Descriptive statistics were used to determine the main characteristics of the cohort, the prevalence of anti-PAD4, the proportion of radiographic scores >0 among those that were +anti-PAD4 and those that were –anti-PAD4 and the distribution of radiographic scores. All the data for this study were analyzed cross-sectionally.

Results: The mean age was 55 years, mean disease duration was 8 years, 86% of the patients were female, 73% were positive for anti-cyclic citrullinated peptide (CCP). The prevalence of anti-PAD4 antibodies was 24% and 91% of the patients that were +anti-PAD4 were also positive for anti-CCP. There were 83% of the +anti-PAD4 patients that had radiographic scores >0 and 63% in the –anti-PAD4 had radiographic scores >0. The mean radiographic scores for the +anti-PAD4 and –anti-PAD4 patients were 52.8 (SD ± 69.7) and 31.0 (SD ± 59.8), respectively (p-value = 0.005).

Conclusion: In this cross-sectional analysis of African American RA patients, the prevalence of anti-PAD4 antibodies among African-American RA patients was similar to that reported in previous RA cohorts of predominantly Caucasian RA patients. African-American patients with +anti-PAD4 were more likely to have higher radiographic scores than those that were –anti-PAD4. Further analyses where the association of anti-PAD4 antibodies is used to determine radiographic progression among African-Americans with RA is warranted.

Disclosure:

I. Navarro-Millan,
None;

A. Westfall,
None;

E. Darrah,
None;

A. Rosen,
None;

T. R. Mikuls,

Genentech/Roche,

R. Reynolds,

NIAMS-NIH,

M. I. Danila,

NIAMS-NIH,

J. R. Curtis,

Roche, Genentech, UCB Pharma, Janssen, CORRONA, Amgen, Pfizer, BMS, Crescendo, AbbVie,

S. L. Bridges Jr.,
None.

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