ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 0038

Arthritis Progression in at Risk Individuals Is Associated with ACPAs Not AMPAs

Alexandra Circiumaru1, Yogan Kisten2, Monika Hansson2, Heidi Wähämaa3, Meng Sun3, Vijay Joshua3, Hamed Rezaei4, Erik Af Klint4, Aleksandra Antovic1, Anca Catrina3 and Aase Haj Hensvold5, 1Division for Rheumatology, Karolinska Institutet; Center for Rheumatology, Academic Specialist Center, Stockholm Region, Stockholm, Sweden, 2Division for Rheumatology, Karolinska Institutet, Stockholm, Sweden, 3Karolinska Institutet and Karolinska university Hospital, Stockholm, Sweden, 4Division for Rheumatology, Karolinska Institutet; Department of Rheumatology, Karolinska University Hospital, Stockholm, Sweden, 5Karolinska Institutet, Division for Rheumatology; & Center for Rheumatology, Academic Specialist Center, Stockholm Region, Stockholm, Sweden

Meeting: ACR Convergence 2021

Keywords: Anti-citrullinated Protein Autoantibodies (ACPAs), rheumatoid arthritis

  • Tweet
  • Email
  • Print
Session Information

Date: Saturday, November 6, 2021

Session Title: RA – Etiology & Pathogenesis Poster (0011–0045)

Session Type: Poster Session A

Session Time: 8:30AM-10:30AM

Background/Purpose: Individuals with anti citrullinated protein antibodies (ACPA) and musculoskeletal complaints are at high risk for developing rheumatoid arthritis (RA) and often seek medical attention due to a symptom burden comparable to that of already diagnosed patients [1] We aimed to investigate the autoimmunity to other autoantibodies, beside ACPA, and study its importance in relation to clinical variables and inflammatory proteins, in risk stratification of predisposed individuals.

Methods: ACPA-positive individuals with musculoskeletal complaints referred from primary care (93%) and other specialist (7%), to a rheumatology clinic were recruited in the Risk-RA Karolinska research program and followed-up for up to 3 years or until arthritis diagnosis (April 2014 and February 2020). In order to investigate early disease mechanisms all individuals lacked both clinical arthritis and subclinical arthritis (measured by ultrasound according to EULAR-OMERACT definitions) in hands, feet and any other symptomatic joints. Blood samples collected at inclusion were analyzed for 14 ACPA specificities along with their arginine counterparts as well as 5 anti-modified protein antibodies (AMPA) against homocitrulline-, acetyl- and lysine- modified filaggrin 307-324 along with acetylated- histone 2B and histone 4 peptides, using custom made peptide array. We further screened for 92 inflammation-associated protein biomarkers (by multiplex immunoassay with Olink extension technology) and HLA-SE (DR low resolution kit). Statistical analysis used univariate and multivariate models with backwards selection and cox regression.

Results: 267 individuals (median age 48 CI: 36-58) were recruited, out of which 210 (78%) were females and with mean presence of 5 ACPA and 1 AMPA reactivities. 79 (30%) developed arthritis within 11 (4-21) months of follow-up compared to 21 (14-28) months median follow-up in those remaining arthritis free. In univariate models, specific ACPAs and AMPAs were associated with progression towards arthritis (Table 1.) Rheumatoid factor positivity (p 0.0003), presence of HLA-SE (p 0.005) and levels of certain inflammatory proteins (CCL20, CXCL6, CXCL9, IL6, IL15, IL17, DNER and TWEAK) associated with arthritis development. In multivariate (backwards selection) cox regression analysis the presence of anti-cit-filaggrin 307-324 (HR 2.1, 95% CI 1.2-3.7, p 0.005), IL6 levels (HR 1.4, 95% CI 1.2-1.7, p< 0.001) and tenosynovitis (HR 2.9, 95% CI 1.7-5.0, p < 0.001) remained significant predictors for arthritis onset. All other types of AMPA for filaggrin lost significance.

Conclusion: Risk-RA phase is characterized by several types of ACPAs and AMPAs, however anti-cit-filaggrin and ACPA reactivities show the strongest risk for progression to arthritis along with inflammatory proteins and ultrasound-detected tenosynovitis. The biological mechanisms need to be further explored in detail.

References:

[1] Studenic P., et al. Symptoms characteristics of seropositive individuals at-risk for developing rheumatoid arthritis are versatile and comparable to those in people with early rheumatoid arthritis, accepted abstract EULAR 2021


Disclosures: A. Circiumaru, None; Y. Kisten, None; M. Hansson, None; H. Wähämaa, None; M. Sun, None; V. Joshua, None; H. Rezaei, None; E. Af Klint, None; A. Antovic, None; A. Catrina, None; A. Haj Hensvold, None.

To cite this abstract in AMA style:

Circiumaru A, Kisten Y, Hansson M, Wähämaa H, Sun M, Joshua V, Rezaei H, Af Klint E, Antovic A, Catrina A, Haj Hensvold A. Arthritis Progression in at Risk Individuals Is Associated with ACPAs Not AMPAs [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/arthritis-progression-in-at-risk-individuals-is-associated-with-acpas-not-ampas/. Accessed January 28, 2023.
  • Tweet
  • Email
  • Print

« Back to ACR Convergence 2021

ACR Meeting Abstracts - https://acrabstracts.org/abstract/arthritis-progression-in-at-risk-individuals-is-associated-with-acpas-not-ampas/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences