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Abstract Number: 508

Before Clinically Detectable Arthritis Develops, ACPA-Positive and ACPA-Negative Arthralgia Patients Have Different Symptoms

Leonie E Burgers1, Hanna W van Steenbergen1, Lukas Mangnus2, Tom WJ Huizinga1 and Annette HM van der Helm-van Mil1, 1Department of Rheumatology, Leiden University Medical Center, Leiden, Netherlands, 2Rheumatology, Department of Rheumatology, Leiden University Medical Center, Leiden, Netherlands

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: anti-citrullinated protein/peptide antibodies (ACPA) and arthritis, Early Rheumatoid Arthritis

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Session Information

Date: Sunday, November 13, 2016

Session Title: Rheumatoid Arthritis – Clinical Aspects - Poster I: Clinical Characteristics/Presentation/Prognosis

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:  Anti-citrullinated protein antibody (ACPA)-positive and ACPA-negative rheumatoid arthritis (RA) have different genetic risk factors and underlying biological mechanisms. Therefore, we hypothesized that patients’ characteristics in the symptomatic phase before clinical arthritis has emerged are also different. We investigated this by studying the arthralgia phase of ACPA-positive and ACPA-negative patients.

Methods:  Patients included in a clinically suspect arthralgia (CSA)-cohort were followed for 2 years or until arthritis development. At inclusion, information on initial symptoms and current symptoms was obtained, physical examination and MRI performed and blood samples taken.

Results were compared between ACPA-positive and ACPA-negative CSA-patients that later developed arthritis. Results: 60 patients (25-ACPA-positive, 35 ACPA-negative) included between April 2012 and March 2016 developed arthritis. 80% of ACPA-negative patients experienced morning stiffness as an initial symptom, compared to 52% of ACPA-positive patients (p=0.022). ACPA-positive patients more often had symptoms in both upper and lower extremities than ACPA-negative patients (40% versus 6%, p=0.001). ACPA-positive patients had a longer symptom duration at first presentation (median of 21.3 weeks versus 10.4 weeks, p=0.016) but converted to arthritis quicker (median 5.7 weeks versus 17.9 weeks after inclusion, p=0.015). A combination of variables clustered ACPA-positive and ACPA-negative patients in PLS-analysis.

Conclusion:  In the phase preceding clinical arthritis, ACPA-negative and ACPA-positive arthralgia patients have different characteristics. This contributes to the notion that ACPA-positive and ACPA-negative RA are different disease subsets.


Disclosure: L. E. Burgers, None; H. W. van Steenbergen, None; L. Mangnus, None; T. W. Huizinga, None; A. H. van der Helm-van Mil, None.

To cite this abstract in AMA style:

Burgers LE, van Steenbergen HW, Mangnus L, Huizinga TW, van der Helm-van Mil AH. Before Clinically Detectable Arthritis Develops, ACPA-Positive and ACPA-Negative Arthralgia Patients Have Different Symptoms [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/before-clinically-detectable-arthritis-develops-acpa-positive-and-acpa-negative-arthralgia-patients-have-different-symptoms/. Accessed January 24, 2021.
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