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Anti-citrullinated peptide antibodies are the strongest predictor of clinically relevant radiographic progression in rheumatoid arthritis patients achieving remission or low disease activity: A post hoc analysis of a nationwide cohort in Japan


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Title: Anti-citrullinated peptide antibodies are the strongest predictor of clinically relevant radiographic progression in rheumatoid arthritis patients achieving remission or low disease activity: A post hoc analysis of a nationwide cohort in Japan
Authors: Koga, Tomohiro / Okada, Akitomo / Fukuda, Takaaki / Hidaka, Toshihiko / Ishii, Tomonori / Ueki, Yukitaka / Kodera, Takao / Nakashima, Munetoshi / Takahashi, Yuichi / Honda, Seiyo / Horai, Yoshiro / Watanabe, Ryu / Okuno, Hiroshi / Aramaki, Toshiyuki / Izumiyama, Tomomasa / Takai, Osamu / Miyashita, Taiichiro / Sato, Shuntaro / Kawashiri, Shin-ya / Iwamoto, Naoki / Ichinose, Kunihiro / Tamai, Mami / Origuchi, Tomoki / Nakamura, Hideki / Aoyagi, Kiyoshi / Eguchi, Katsumi / Kawakami, Atsushi
Issue Date: 15-May-2017
Publisher: Public Library of Science
Citation: PLOS ONE, 12(5), e0175281; 2017
Abstract: Objectives: To determine prognostic factors of clinically relevant radiographic progression (CRRP) in patients with rheumatoid arthritis (RA) achieving remission or low disease activity (LDA) in clinical practice. Methods: Using data from a nationwide, multicenter, prospective study in Japan, we evaluated 198 biological disease-modifying antirheumatic drug (bDMARD)-naïve RA patients who were in remission or had LDA at study entry after being treated with conventional synthetic DMARDs (csDMARDs). CRRP was defined as the yearly progression of modified total Sharp score (mTSS) >3.0 U. We performed a multiple logistic regression analysis to explore the factors to predict CRRP at 1 year. We used receiver operating characteristic (ROC) curve to estimate the performance of relevant variables for predicting CRRP. Results: The mean Disease Activity Score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR) was 2.32-0.58 at study entry. During the 1-year observation, remission or LDA persisted in 72% of the patients. CRRP was observed in 7.6% of the patients. The multiple logistic regression analysis revealed that the independent variables to predict the development of CRRP were: anti-citrullinated peptide antibodies (ACPA) positivity at baseline (OR = 15.2, 95%CI 2.64-299), time-integrated DAS28-ESR during the 1 year post-baseline (7.85-unit increase, OR = 1.83, 95%CI 1.03-3.45), and the mTSS at baseline (13-unit increase, OR = 1.22, 95% CI 1.06-1.42). Conclusions: ACPA positivity was the strongest independent predictor of CRRP in patients with RA in remission or LDA. Physicians should recognize ACPA as a poor-prognosis factor regarding the radiographic outcome of RA, even among patients showing a clinically favorable response to DMARDs.
URI: http://hdl.handle.net/10069/37587
DOI: 10.1371/journal.pone.0175281
Rights: © 2017 Koga et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/37587

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