Association Between Anti-Cyclic Citrullinated Peptide Antibodies Titres and The Presence and Severity Of Diffuse Interstitial Lung Disease Secondary To Rheumatoid Arthritis

Juan Manuel Ponce-Guarneros¹, Alberto Daniel Rocha Muñoz², Jorge Ivan Gámez Nava³, Soraya Amalí Zavaleta Muñíz⁴, Miriam Lizette Díaz Toscano⁵, Mario Salazar Paramo⁶, Liliana Faviola De La Cerda Trujillo⁷, Norma Guadalupe González Montoya³, Ernesto German Cardona Muñoz⁸, Monica Vazquez del Mercado⁹ and Laura González López¹⁰, ¹Medidina Interna-Reumatología, Hospital General Regional 110, Instituto Mexicano del Seguro Social. Guadalajara., Guadalajara, Jalisco, Mexico, ²Institute for Research in Rheumatology and Musculoskeletal System, Guadalajara, Jalisco, Mexico, ³Unidad de Investigación en Epidemiología Clínica, Hospital de Especialidades Centro Médico Nacional de Occidente., Guadalajara, Jalisco, Mexico, ⁴Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético, Universidad de Guadalajara, Guadalajara, Jalisco, México, Mexico, ⁵Fisiología, Doctorado en Farmacología, Centro Universitario de Ciencias de la Salud, Guadalajara, Jalisco, Mexico, ⁶Clinical Research Division, Instituto Mexicano Del SS, Guadalajara, Mexico, ⁷Unidad de Investigación en Epidemiología Clínica del Hospital de Especialidades Centro Médico Nacional de Occidente, IMSS, Guadalajara, Jalisco, Mexico, ⁸Departamento de Fisiología, Universidad de Guadalajara, Guadalajara, México, Guadalajara, Jalisco, Mexico, ⁹Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético, Universidad de Guadalajara, Guadalajara, Mexico, ¹⁰Medicina Interna-Reumatología, Departamento de Medicina Interna-Reumatología, Hospital General Regional 110, Instituto Mexicano del Seguro Social., Guadalajara, Jalisco, Mexico

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Anti-CCP antibodies and rheumatoid arthritis (RA)

Session Information

Title: Rheumatoid Arthritis - Clinical Aspects I: Comorbidities in Rheumatoid Arthritis

Session Type: Abstract Submissions (ACR)

Background/Purpose: To evaluate the association between anti-cyclic citrullinated peptide antibody titres (anti-CCP) and other clinical factors with the presence and severity of Interstitial Lung Disease in patients with Rheumatoid Arthritis (ILD-RA).

Methods: A total of 81 RA patients were included in a cross-sectional study. Forty-one patients with ILD-RA were compared with 40 Rheumatoid Arthritis without pulmonary involvement (RA w/out). ILD was screened with pulmonary function tests (PFT) and diagnosed by definite findings in the high-resolution computed tomography (HRCT). Clinical impact of ILD was evaluated with PFP, six-minute walk test (6MWT); Borg scale, Saint George’s respiratory scale (SGRQ), and severity of ILD according to the HRCT score. Serum anti-CCP levels were measured by ELISA. Multivariate logistic regression was conducted to identify independent risk factors for ILD-RA.

Results: There was no difference in the frequency of smoking history between the group ILD-RA compared with the group of RA w/out (23.1% vs. 31.0% respectively, p = 0.46). The group of ILD-RA has higher score of DAS28 compared with RA w/out (3.59 ± 1.09 vs. 2.77 ± 0.84 respectively, p <0.001), HAQ-Di, (0.90 ± 0.52 vs. 0.58 ± 0.45 respectively, p < 0.05) and higher frequency of positive anti-CCP (100% vs. 64.3%, p < 0.001). Anti-CCP titres correlated with severity of dyspnea (r=0.535, p <0.001), SGRQ symptoms (r = 0.547, p <0.001), SGRQ activity (r = 0.616, p <0.001), SGRQ impact (r = 0.523, p <0.001), HCRT alveolar score (r = 0.695, p <0.001), HCRT interstitial score (r = 0.547, p <0.001) and HCRT total score (r = 0.549, p <0.001). In the multivariate analysis, after adjusting by age, disease duration, smoking status and disease activity anti-CCP titres remained as a risk factor (OR, 1.06; 95%CI, 1.02-1.10; p= 0.001) as well as duration of treatment with methotrexate (OR, 2.82; 95%CI, 1.51-5.29 p = 0.001).

Conclusion:

High anti-CCP titers are associated with the severity of the ILD secondary to RA. Follow-up studies are required to identify if patients with higher titers of this antibody are associated with a poor outcome in patients suffering ILD-RA.

Funding: FIS/IMSS/PROTMD11/998

Disclosure:

J. M. Ponce-Guarneros,
None;

A. D. Rocha Muñoz,
None;

J. I. Gámez Nava,
None;

S. A. Zavaleta Muñíz,
None;

M. L. Díaz Toscano,
None;

M. Salazar Paramo,
None;

L. F. De La Cerda Trujillo,
None;

N. G. González Montoya,
None;

E. G. Cardona Muñoz,
None;

M. Vazquez del Mercado,
None;

L. González López,
None.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-between-anti-cyclic-citrullinated-peptide-antibodies-titres-and-the-presence-and-severity-of-diffuse-interstitial-lung-disease-secondary-to-rheumatoid-arthritis/