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Association of the Presence of Anti–Carbamylated Protein Antibodies in Early Arthritis With a Poorer Clinical and Radiologic Outcome
Author(s) -
Truchetet MarieElise,
Dublanc Stéphanie,
Barnetche Thomas,
Vittecoq Olivier,
Mariette Xavier,
Richez Christophe,
Blanco Patrick,
Mahler Michael,
ContinBordes Cécile,
Schaeverbeke Thierry
Publication year - 2017
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.40237
Subject(s) - medicine , rheumatoid arthritis , rheumatoid factor , carp , antibody , cohort , arthritis , odds ratio , population , erythrocyte sedimentation rate , risk factor , gastroenterology , immunology , biology , fish <actinopterygii> , environmental health , fishery
Objective To assess the prevalence of anti–carbamylated protein (anti‐CarP) antibodies in a French cohort of patients with early arthritis and to investigate their association with clinical features, final diagnosis, prognosis, and comorbidities. Methods The presence of anti‐CarP antibodies among patients with early arthritis in the French Etude et Suivi des Polyarthrites Indifférenciées Récentes ( ESPOIR ) cohort (n = 720) was determined using enzyme‐linked immunosorbent assay. We investigated the prevalence of anti‐CarP antibodies in different patient subgroups stratified according to anti–citrullinated protein antibody ( ACPA ) and/or rheumatoid factor ( RF ) status. Diagnostic and prognostic values of the test were evaluated in this population. Results Anti‐CarP antibodies were present in approximately one‐third of the patients (32.6%) and in 23.6% of the patients who were seronegative for both RF and ACPA . Anti‐CarP positivity was associated with a more active disease status at baseline and over time. Anti‐CarP–positive patients had a significantly higher Disease Activity Score in 28 joints using the erythrocyte sedimentation rate at month 36 than anti‐CarP–negative patients (3.1 ± 0.11 versus 2.8 ± 0.06; P = 0.03). Anti‐CarP–positive early arthritis was associated with a higher risk of developing erosions after 96 months of follow‐up (55.6% of anti‐CarP–positive patients versus 37.3% of anti‐CarP–negative patients) (odds ratio 2.1 [95% CI 1.2–3.6]; P = 0.009). This association was particularly true when anti‐CarP was associated with ACPA positivity. Moreover, ACPA positivity alone in early arthritis was not associated with a higher risk of erosive evolution. Conclusion Our findings indicate that anti‐CarP antibodies are present in one‐third of patients with early arthritis and in one‐fourth of the RF ‐negative and ACPA ‐negative patients. They are particularly associated with a more severe radiographic outcome. Anti‐CarP antibody positivity may help to accurately identify those at risk of erosive evolution in an early arthritis population.