MRI-Detected Osteitis Is Not Associated with the Presence or Level of ACPA Alone, but with the Combined Presence of ACPA and RF

Debbie M. Boeters¹, Wouter P. Nieuwenhuis¹, Marije K. Verheul¹, Elize C. Newsum¹, Monique Reijnierse², René E.M. Toes¹, Leendert A. Trouw¹ and Annette H.M. van der Helm-van Mil¹, ¹Department of Rheumatology, Leiden University Medical Center, Leiden, Netherlands, ²Department of Radiology, 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), bone marrow lesions and rheumatoid arthritis (RA), MRI, Rheumatoid Factor

Session Information

Date: Sunday, November 13, 2016

Title: Rheumatoid Arthritis – Human Etiology and Pathogenesis - Poster I

Session Type: ACR Poster Session A

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

Background/Purpose: Within rheumatoid arthritis (RA) bone marrow edema (BME, osteitis) and anti-citrullinated protein antibodies (ACPAs) are associated with radiographic progression. ACPA has been associated with BME, but it is unknown if this association is confined to ACPA and BME. We cross-sectionally studied the association of ACPA, rheumatoid factor (RF) and anti-carbamylated protein (anti-CarP) antibodies with BME and other types of MRI-detected inflammation (synovitis, tenosynovitis).

Methods: 589 DMARD-naïve early arthritis patients, included in the Leiden Early Arthritis Clinic, underwent contrast-enhanced 1.5T MRI of unilateral wrist, metacarpophalangeal and metatarsophalangeal-joints at baseline. BME, synovitis and tenosynovitis were scored by two readers. ACPA, RF and anti-CarP were determined at baseline.

Results: In univariable analyses ACPA-positive patients had higher BME-scores than ACPA-negative patients (median 4.5 vs. 2.0, p<0.001), but not more synovitis and tenosynovitis. Also RF (median 3.75 vs. 2.0, p<0.001) and anti-CarP antibodies (median 3.5 vs. 2.5, p=0.012) were associated with higher BME-scores. Because the autoantibodies were concomitantly present, analyses were stratified for the presence of different autoantibody combinations. ACPA+RF-anti-CarP- patients did not have higher BME-scores than ACPA-RF-anti-CarP- patients. However ACPA+RF+anti-CarP- and ACPA+RF+anti-CarP+ patients had higher BME-scores than ACPA-RF-anti-CarP- patients (median 5.0 and 4.5 vs. 2.0, p<0.001 and p<0.001). ACPA levels were not associated with BME-scores. Analyses within RA- and UA-patients revealed similar results.

Conclusion: The single presence of ACPA and ACPA-level were not statistically significant associated with BME-scores, but the combined presence of ACPA and RF did associate with more BME. This suggests an additive role of RF to ACPA in mediating osteitis.

Disclosure: D. M. Boeters, None; W. P. Nieuwenhuis, None; M. K. Verheul, None; E. C. Newsum, None; M. Reijnierse, None; R. E. M. Toes, None; L. A. Trouw, None; A. H. M. van der Helm-van Mil, None.

To cite this abstract in AMA style:

Boeters DM, Nieuwenhuis WP, Verheul MK, Newsum EC, Reijnierse M, Toes REM, Trouw LA, van der Helm-van Mil AHM. MRI-Detected Osteitis Is Not Associated with the Presence or Level of ACPA Alone, but with the Combined Presence of ACPA and RF [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/mri-detected-osteitis-is-not-associated-with-the-presence-or-level-of-acpa-alone-but-with-the-combined-presence-of-acpa-and-rf/. Accessed .

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