ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1758

Development of Ultrasound Detectable Arthritis Among ACPA Positive Subjects with Musculoskeletal Symptoms: The Risk RA Prospective Study

Aase Hensvold1, Yogan Kisten 2, Alexandra Circiumaru 1, Monika Hansson 3, Meng Sun 1, Guozhong Fei 4, Nancy Vivar 2, Erik af Klint 2, Hamed Rezaei 2, Lars Klareskog 3, Aleksandra Antovic 5 and Anca Catrina 3, 1Rheumatology unit Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden, Stockholm, 2Rheumatology unit Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden, Stockholm, Stockholms Lan, Sweden, 3Rheumatology unit Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden, Stockholm, Sweden, 4Center for Rheumatology, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden, Stockholm, Sweden, 5Center for Rheumatology, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden, Stockholm, Stockholms Lan, Sweden

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: anti-citrullinated protein/peptide antibodies (ACPA), Doppler ultrasound, Early Rheumatoid Arthritis and biomarkers, risk assessment

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Monday, November 11, 2019

Session Title: 4M046: Plenary II (1758–1763)

Session Type: Plenary Session II

Session Time: 11:00AM-12:30PM

Background/Purpose: Studies have shown that anti-citrullinated protein antibodies (ACPA) are a risk factor for the development of arthritis. We aimed to investigate in a prospective setting whether ACPA and other biomarkers could predict the development of ultrasound detected arthritis

Methods: Subjects with positive ACPA-test referred from primary-care to the Rheumatology clinic, that lacked arthritis in the hands, feet and any other symptomatic joints by clinical and ultrasound examination (according to EULAR-OMERACT definition), were recruited into the Risk-RA research program during 2015-2016, and were followed-up to the end of January 2019. at inclusion, a detailed clinical examination was performed and blood samples were analyzed for 13 specific ACPA reactivities (using custom made peptide microarray) as well as 92 inflammation-associated protein biomarkers (using a multiplex immunoassay with Olink proximity extension technology). Presence of HLA-SE was analyzed using DR low-resolution kit. Univariate and multivariate analysis were used to investigate the association between clinical and laboratory parameters and development of ultrasound detected arthritis adjusting for the follow-up time.

Results: 46% (30 out of 65) of the Risk RA subjects developed ultrasound detectable arthritis during a median follow-up time of 11 months. The remaining 54% (35 out of 55) were followed for a median of 27 months (range 17-39) without any signs of ultrasound detectable arthritis. Those subjects that developed arthritis had a higher prevalence of HLA-SE (83% vs 55%) as well as an increased incidence of ultrasound detected tenosynovitis (40% vs 5%) as compared to those that did-not develop arthritis. ACPA reactivities to citrullinated vimentim peptides (cit vim 2-17: 20% vs 6%; and cit vim 60-75: 67% vs 44%) and citrullinated histone peptides (cit H4 31-50: 87% vs 47%; and cit H3 21-44: 47% vs 22%) were a more common occurrence in subjects developing ultrasound detectable arthritis.
Backward selection in Cox regression model showed that ultrasound detectable arthritis could be predicted in a model including HLA-SE, tenosynovitis and ACPA reactivity to cit H4 31-50. Hazard ratio (HR) for arthritis development were 2.2 (95% CI 0.8-6, p=0.13) for HLA-SE carriers and 2.9 (95% CI 1.3-6.5, p=0.01) for tenosynovitis, and 3.4 (95% CI 1.2-10, p=0.02) for Anti-citrullinated H4 31-50 positivity. Only modest differences were observed for few of the tested inflammatory markers in those developing as compared to those not developing ultrasound detectable arthritis: Interleukin- 6 (3.9 vs 3.3 AU/ML), Programmed death-ligand 1 (4.9 vs 5.2 AU/ML) and Chemokine (C-X-C motif) ligand 6 (9.2 vs 9.5 AU/ML).

Conclusion: Certain ACPA fine specificities, HLA-SE and tenosynovitis predicts the development of ultrasound detectable arthritis in seropositive individuals with musculoskeletal symptoms who are at risk for RA.


Disclosure: A. Hensvold, None; Y. Kisten, None; A. Circiumaru, None; M. Hansson, None; M. Sun, None; G. Fei, None; N. Vivar, None; E. af Klint, None; H. Rezaei, None; L. Klareskog, BMS, 2, Janssen, 2, Pfizer, 2; A. Antovic, None; A. Catrina, None.

To cite this abstract in AMA style:

Hensvold A, Kisten Y, Circiumaru A, Hansson M, Sun M, Fei G, Vivar N, af Klint E, Rezaei H, Klareskog L, Antovic A, Catrina A. Development of Ultrasound Detectable Arthritis Among ACPA Positive Subjects with Musculoskeletal Symptoms: The Risk RA Prospective Study [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/development-of-ultrasound-detectable-arthritis-among-acpa-positive-subjects-with-musculoskeletal-symptoms-the-risk-ra-prospective-study/. Accessed April 17, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2019 ACR/ARP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/development-of-ultrasound-detectable-arthritis-among-acpa-positive-subjects-with-musculoskeletal-symptoms-the-risk-ra-prospective-study/

Advanced Search

Your Favorites

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

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.