Korean J Intern Med.  2010 Jun;25(2):201-206. 10.3904/kjim.2010.25.2.201.

Correlation of Anti-Cyclic Citrullinated Antibody with Hand Joint Erosion Score in Rheumatoid Arthritis Patients

• Kim HH
• Kim J
• Park SH
• Kim SK
• Kim OD
• Choe JY

• KMID: 1785679
• DOI: http://doi.org/10.3904/kjim.2010.25.2.201

Abstract

BACKGROUND/AIMS
To examine the correlation between radiological joint damage and serological parameters in early rheumatoid arthritis (RA). METHODS: This retrospective study reviewed the records of 216 patients diagnosed with RA and classified them according to disease duration: group 1, < or = 24 months; group 2, > 24 months; and group 3, all patients combined. The extent of joint damage was assessed from plain radiographs using a modified version of the Larsen method and compared among groups. RESULTS: The mean radiographic joint damage score was significantly higher in patients who had established RA (10.1 points) compared with those who had early RA. In group 1, the inflammatory parameters, erythrocyte sedimentation rate, and C-reactive protein were positively correlated with the joint damage score, but rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibody were not. A subgroup analysis revealed that the anti-CCP positive patients in groups 1 and 2 had greater joint damage scores than did the anti-CCP negative patients, but no difference in RF was observed between subgroups. Anti-CCP positivity was not significantly correlated with joint damage sores in group 3. CONCLUSIONS: Anti-CCP positivity was significantly correlated with more severe joint damage at diagnosis. A correlation was observed between the radiological joint damage score and inflammatory parameters in early and established RA, indicating that anti-CCP can serve as a diagnostic tool and predict structural joint damage. These findings suggest anti-CCP positive patients should receive aggressive therapeutic intervention.

Keyword

Arthritis, rheumatoid; Rheumatoid factor; Cyclic citrullinated peptide; Joint disease

MeSH Terms

Adult
Arthritis, Rheumatoid/*immunology/*radiography
Autoantibodies/*blood
*Biological Markers
Early Diagnosis
Female
Finger Joint/radiography
Humans
Male
Metacarpophalangeal Joint/radiography
Middle Aged
Peptides, Cyclic/*immunology
Retrospective Studies
Severity of Illness Index
Wrist Joint/radiography