Anti\CCP antibodies and RF predicted RA in patients with polyarthritic disease. Acknowledgements We are grateful to Tord Johansson of the Department of Medical Biochemistry and Biophysics/Omnio, University Hospital Umea, for excellent technical assistance. The study was supported by grants from your Swedish Psoriasis Association. Abbreviations ACR – American College of Rheumatology CCP – cyclic citrullinated peptide DIP – distal interphalangeal PsA – psoriatic arthritis RA – rheumatoid arthritis RF – rheumatoid factor Footnotes Competing interests: None declared.. with psoriasis without arthritis, but less prevalent than in patients with early RA. Patients with PsA positive for anti\CCP antibodies more often experienced polyarthritic disease, but the presence of anti\CCP antibodies did not relate to radiological changes and/or deformity and functional impairment. 3.0, p 0.001 and 11.5 5.0, p 0.001, respectively). There were no correlations between the titres of anti\CCP antibodies and the number of swollen or tender joints, either in the patients with PsA or with early RA. Nor was the presence of Erlotinib HCl anti\CCP antibodies related to aggressive manifestations such as radiological changes and/or deformity and functional impairment in PsA. At a 4?12 months follow up examination, 8/11 patients with PsA positive for anti\CCP had a polyarthritic disease and all fulfilled ?4 of the ACR criteria for RA.11 Five of these eight patients also had manifestations such as dactylitis, DIP involvement, radiological changes associated with PsA, and/or enthesitis (table 1?1).). In multiple logistic regression analysis with polyarthritis (based on ACR joint count) as a dependent variable, anti\CCP antibodies (p 0.001, odds ratio (OR)?=?6.53, 95% confidence interval (CI) 2.32 to 18.37) and RF (p 0.001, OR?=?11.10, 95% CI 4.09 to 30.16) significantly distinguished between RA and PsA (data not shown). Table 1?Details of the 11 patients positive for anti\CCP diagnosed as PsA at inclusion in the study, and disease manifestations at the 4?12 months follow up examination thead th colspan=”4″ align=”left” valign=”bottom” rowspan=”1″ At inclusion in the study /th th colspan=”4″ align=”left” valign=”bottom” rowspan=”1″ At 4?12 months follow up examination /th th align=”left” valign=”bottom” rowspan=”1″ colspan=”1″ Erlotinib HCl Age/sex /th th align=”left” valign=”bottom” rowspan=”1″ colspan=”1″ Disease pattern /th th align=”left” valign=”bottom” rowspan=”1″ colspan=”1″ RF /th th colspan=”2″ align=”left” valign=”bottom” rowspan=”1″ Mouse monoclonal to HDAC4 Anti\CCP antibody (titre) /th th align=”left” valign=”bottom” rowspan=”1″ colspan=”1″ ?4 of the ACR criteria for RA /th th colspan=”2″ align=”left” valign=”bottom” rowspan=”1″ Disease manifestations Erlotinib HCl and actual treatment /th /thead 68/MAxial disease060.00No disease activity48/FMono\oligoarthritis080.40Medium disease activity. Methotrexate+sulfasalazine30/MOligoarthritis32067.30No disease activity, no radiological changes in the joints of the feet67/FPolyarthritis + axial disease8035.61Low disease activity. Sulfasalazine63/MPolyarthritis + axial disease8019.61Low\medium disease activity, enthesitis, DIP and MTP joints, knees, back involvement. Sulfasalazine65/MPolyarthritis160113.21High disease activity, back involvement, enthesitis, no swollen joints, DIP joint involvement50/FPolyarthritis8013.11Medium\high disease activity, radiological destruction hands, feet, destruction MCP II sin, joint/tuft osteolysis MTP I (pencil in cup). Remicade33/FPolyarthritis1605.41Medium disease activity, clinically active PsA, joint function impairment, radiological destruction MCP I sin. Methotrexate + platinum injections61/MPolyarthritis320122.51Low disease activity. Prednisolone56/FPolyarthritis320123.31Disease activity75/MPolyarthritis320256.31Low disease activity. Auranofin Open in a separate window Discussion In this study the prevalence of anti\CCP antibodies was increased in patients with psoriasis with arthritis compared with patients with psoriasis without arthritis; however, the prevalence was significantly lower than in patients with early RA. Only 11 patients with PsA were positive for anti\CCP antibodies, most of whom fulfilled the ACR criteria for RA at 4?12 months follow up. Most frequently they fulfilled the criteria of positive RF, polyarthritis, arthritis in the hands, and morning stiffness. However, some of the patients fulfilling the criteria for RA experienced clinical signs associated with PsA, demonstrating the complexity and difficulty in diagnosing the two diseases. The number of patients with PsA positive for anti\CCP antibodies was not sufficient to stratify for subgroup analysis. Although the presence of anti\CCP antibodies did not correlate with the number of swollen or tender joints, it seemed, when each positive patient was evaluated separately, that anti\CCP antibodies in patients with PsA were related to polyarthritis and the presence of RF rather than to RA as defined by the ACR criteria. On the other hand, there is a possibility that this patients.