Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: The prevalence of Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies in the general population may vary widely, as RF is present in 0-5% and anti-CCP in 0-9% of healthy controls, but the clinical significance in the general population remains unclear. We determined the prevalence of RF and anti-CCP antibodies in a large sample of the general population and their predictive value over developing rheumatoid arthritis (RA) over 16 years.
Methods: We took advantage of a randomly selected sample of a general population study initiated in 1998 (Isola I, originally including 2,828 subjects; 53% women, age 43±13 years) from a well-defined Northern Italian area. Serum RF and anti-CCP were tested in recent years by ELISA on 2,690 samples and data collected in 2017 (Isola II: 50% women, age 58±13 years). Administrative databases were searched for RA diagnoses occurring between enrollment and May 31st 2017. The risk ratio (RR) was calculated for incident RA cases between subjects exposed and not exposed to RF and anti-CCP antibodies.
Results: RF was positive in 276 (10.2%), while anti-CCP were found in 127 (4.7%) subjects, with the latter at medium-high titer (>30 U/mL) in 25 (0.9%) subjects. Twelve (0.4%) cases of RA were found over 16 years, of which 3 (25%) positive for RF and 5 (41.7%) positive for anti-CCP antibodies, mostly at medium-high titer (4/5, 80%). Only one (8.3%) case of RA was positive both for RF and anti-CCP antibodies. We observed two cases of Sjögren’s syndrome, both positive for RF, while one was positive also for anti-CCP. The risk ratio (RR) of developing RA over 16 years is 3.08 (95% confidence interval – CI – 0.82-11.56, p=0.07) for RF positive subjects and 20.13 (95% CI 5.09-79-52, p<0.001), for anti-CCP antibodies positive subjects, and it increases up to 67.46 (95%CI 16.36-253.98; p<0.001) for medium-high titer anti-CCP antibodies.
Conclusion: We report a high prevalence of RF and anti-CCP in the general population of a Northern Italian region, but only anti-CCP are associated with a significantly increased risk of RA over 16 years.
To cite this abstract in AMA style:Generali E, Isailovic N, De Santis M, Ceribelli A, Alborghetti F, Colloredo G, Porrati L, Matthias T, Zucchi A, Guidelli GM, Caprioli M, Selmi C. Prevalence and Predictive Value over 16 Years of Serum Rheumatoid Factor and Anti-Cyclic Citrullinated Peptide Antibodies in the General Population [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/prevalence-and-predictive-value-over-16-years-of-serum-rheumatoid-factor-and-anti-cyclic-citrullinated-peptide-antibodies-in-the-general-population/. Accessed November 18, 2019.
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