ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 421

Rheumatoid Factor, Not Antibodies to Citrullinated Proteins, Are Associated with High Disease Activity

Josef S. Smolen1, Farideh Alasti2 and Daniel Aletaha3, 1Medical University of Vienna and Hietzing Hospital, Vienna, Austria, 2Department of Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria, 3Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Activity score, anti-citrullinated protein/peptide antibodies (ACPA), outcome measures and rheumatoid arthritis (RA)

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Title: Rheumatoid Arthritis - Human Etiology and Pathogenisis

Session Type: Abstract Submissions (ACR)

Background/Purpose: Autoantibodies in general, and rheumatoid factor (RF) and anti-citrullinated peptide antibodies (ACPA) in particular, are a hallmark of RA. After their characterization, ACPA have been regarded as more specific than RF in relation to diagnostic and prognostic utility. However, these data have not been unequivocally shared throughout the literature and most of them have come from observational studies, often from a single or few centers. While it has been known for long that RF+ patients have more active and severe disease than RF- ones, it is not clear if this effect is due to RF, ACPA or both in the light of the high (usually >80%) overlap of RF and ACPA positivity and the above  controversy. Here we compared the extent of disease activity in RF+ and/or ACPA+ patients to understand the impact of these autoantibodies on disease activity of RA.

Methods: We were kindly provided a large database of patient level data from an international multicenter clinical trial comparing methotrexate (MTX) and rituximab plus MTX in patients with early (<4 years) arthritis who had to be MTX-naïve and fulfill a predefined level of active disease (≥8 swollen and tender joints) and be RF+ or have erosive disease at entry (IMAGE trial)1. Core set variables as well as levels of RF (by nephelometry) and ACPA (by ELISA) were available from the database. For the purpose of this analysis, we focused on baseline data and pooled the patients of all three treatment groups. The following groups were formed four groups according to the presence/absence of RF and ACPA. We compared disease activity variables and indices (disease activity score, DAS28; simplified and clinical disease activity index, SDAI and CDAI) across these groups using the Kruskal Wallis test for overall assessment, and the Wilcoxon test for subsequent pairwise comparisons if appropriate. A main focus of the latter was the comparison of the RF+/ACPA- and RF-/ACPA+ populations compared to each other.

Results:

At baseline, disease activity was 6.9, 7.1, 7.1 and 6.6 by the DAS28 for RF-/ACPA- (n=64); RF+/ACPA+ (n=611); RF+/ACPA- (n=40); RF-/ACPA+ (n=29), respectively; and 47.8, 49.8, 53.1, 42.3 for the SDAI, significantly different among the four groups for both measures. The lowest values of disease activity measures were seen for the RF-/ACPA+ population, and significantly lower than in the RF+/ACPA- group (p=0.014 for DAS28, and p=0.004 for SDAI). Similar findings were made for CDAI, swollen and tender joint counts, while for ESR and CRP there was a numerical trend in this direction (not shown). Interestingly, patients positive for both RF and ACPA tended to have slightly lower disease activity than RF+/ACPA-, and higher than RF-/ACPA+ ones. Importantly, similar findings were made for the baseline values of each of the three trial arms when assessed individually (not shown).

Conclusion:

The data presented suggest that RF may contribute more strongly to disease activity than ACPA and, therefore, may have more direct pathogenetic implications. Confirmation of these findings in other trial databases would shed more light on this insight.

Acknowledgment. We thank Roche for kindly providing the data of this study.

1. Tak,P.P. et al. Ann Rheum Dis 70, 39-46 (2011)


Disclosure:

J. S. Smolen,

Abbott, BMS, MSD, Pfizer, Roche, UCB,

2,

Abbott, Amgen, Astra-Zeneca, BMS, Celgene, Glaxo, Medimmune, MSD, Novo-Nordisk, Pfizer,Roche, Sandoz, UCB,

5,

Mosby-Elsevier,

7;

F. Alasti,
None;

D. Aletaha,

MSD,

2,

Abbott, BMS, Grünenthal, MSD, Pfizer, Roche, UCB,

5.

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2012 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/rheumatoid-factor-not-antibodies-to-citrullinated-proteins-are-associated-with-high-disease-activity/

Advanced Search

Your Favorites

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

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology