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.
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 October 27, 2020.
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ACR Meeting Abstracts - 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/