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  1. Home
  3. Identification Of Early Risk Factors For Anti-citrullinated-protein-antibody Positive Rheumatoid Arthritis-a Prospective Cohort Study.
  1. Home
  3. Identification Of Early Risk Factors For Anti-citrullinated-protein-antibody Positive Rheumatoid Arthritis-a Prospective Cohort Study.

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Identification of early risk factors for anti-citrullinated-protein-antibody positive rheumatoid arthritis-a

Alexandra Cîrciumaru1,2, Yogan Kisten1, Monika Hansson1,3

  • 1Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.

Rheumatology (Oxford, England)
|March 8, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

Individuals with anti-CCP antibodies and musculoskeletal complaints who have ACPA reactivity, tenosynovitis, IL-6, and IL-15Rα are at high risk for rheumatoid arthritis progression. These factors can help identify individuals at high or low risk for developing arthritis.

Keywords:
anti-citrullinated protein antibody reactivitiesbiomarkersrheumatoid arthritisrisk phase

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Area of Science:

  • Rheumatology
  • Immunology
  • Biomarkers

Background:

  • Individuals with anti-cyclic-peptide-antibodies (anti-CCP) and musculoskeletal complaints (MSK-C) are at elevated risk for developing rheumatoid arthritis (RA).
  • Early identification of individuals progressing to RA is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

  • To investigate factors predicting arthritis progression in anti-CCP-positive individuals with MSK-C.
  • To identify a distinct high-risk phase for RA development.

Main Methods:

  • Recruitment of anti-CCP2-positive individuals with MSK-C lacking arthritis at baseline.
  • Longitudinal follow-up (≥3 years) with clinical and ultrasound assessments.
  • Analysis of autoantibodies (ACPA reactivities), inflammation-associated proteins (IL-6, IL-15Rα), and HLA alleles using Cox regression.

Main Results:

  • 101 out of 267 participants (38%) developed arthritis.
  • Significant independent predictors for arthritis progression included: presence of ACPA reactivity (HR 8.0), ultrasound-detected tenosynovitis (HR 3.4), elevated IL-6 levels (HR 1.5), and IL-15 receptor α (IL-15Rα) levels (HR 0.6).
  • The prediction model demonstrated good performance (AUC 0.82).

Conclusions:

  • A high RA risk phase is characterized by ACPA reactivity, tenosynovitis, IL-6, and IL-15Rα.
  • These factors warrant further investigation for their clinical utility in stratifying individuals by arthritis progression risk.
  • This could enable personalized risk assessment and management strategies.