Anti-Citrullinated Protein Antibody Titers Are Independently Modulated by Both Disease Activity and Conventional or Biologic Anti-Rheumatic Drugs
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Population and Study Design
2.2. Variables
2.3. Anti-Citrullinated Protein Antibody Measurements
2.4. Statistical Analysis
3. Results
3.1. Study Population
3.2. Baseline Anti-CCP2 Levels and Their Evolution along the Follow-Up
3.3. Factors Influencing Anti-CCP2 ACPA Titers
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Sex n (%) | Male | 18 (13.85%) |
Female | 112 (86.15%) | |
Diagnosis at baseline (ACR/EULAR Criteria 2010) n (%) | Rheumatoid Arthritis | 108 (83.08%) |
Undifferentiated arthritis | 22 (16.92%) | |
Age at onset n (%) | <45 years | 42 (32.31%) |
45–65 years | 58 (44.62%) | |
>65 years | 30 (23.08%) | |
Mean (SD) | 52.64 (15.12) | |
Race, ethnicity n (%) | Caucasian | 108 (83.08%) |
Latin American | 22 (16.92%) | |
Smoking n (%) | Never-smoker | 65 (50.78%) |
Former smoker | 30 (23.44%) | |
Active smoker | 33 (25.78%) | |
Time of evolution to recruitment (weeks) | Median (IQR) | 6 (3.6–8.97) |
Baseline anti-CCP2 titers | Median (IRQ) | 460.3 (160–1280) |
Baseline DAS28 | Median (IQR) | 4.53 (3.47–5.63) |
Baseline HUPI | Median (IQR) | 7 (5–10) |
Baseline HAQ | Median (IQR) | 1 (0.5–1.63) |
Baseline CRP | Median (IQR) | 0.7 (0.2–1.5) |
Drug | Visit 1 (n = 124) | Visit 2 (n = 98) | Visit 3 (n = 97) | Visit 4 (n = 102) | Visit 5 (n = 48) |
---|---|---|---|---|---|
Glucocorticoids | 27.63% | 54.07% | 45.36% | 25.49% | 22.92% |
Methotrexate | 19.35% | 83.67% | 75.26% | 70.59% | 68.75% |
Leflunomide | 0.81% | 11.22% | 22.68% | 23.53% | 31.25% |
Anti-malarials | 4.84% | 17.35% | 20.62% | 17.65% | 18.75% |
Sulphasalazine | 0.81% | 5.10% | 4.12% | 6.86% | 10.42% |
Gold salts | 0.81% | 1.02% | 2.06% | 1.96% | 0% |
Anti-TNF | 0% | 1.02% | 5.15% | 5.88% | 18.75% |
Tocilizumab | 0% | 0% | 0% | 1.96% | 0% |
Rituximab | 0% | 0% | 0% | 0.98% | 2.08% |
Combination therapy | 3.08% | 23.21% | 29.2% | 37.4% | 53.97% |
Independent Variable | β Coefficient | 95%CI | p Value | |
---|---|---|---|---|
Smoking | Never | Reference category | ||
Former smoker | 4.09 | −0.67–8.85 | 0.092 | |
Smoker | 9.26 | 4.59–13.92 | <0.001 | |
Disease activity (HUPI) | Remission | Reference category | ||
Mild | 2.30 | 0.48–4.11 | 0.013 | |
Moderate | 2.35 | 0.21–4.48 | 0.031 | |
High | 3.76 | 1.18–6.34 | 0.004 | |
Glucocorticoids (mg/day) | −0.10 | −0.24–0.41 | 0.162 | |
Methotrexate Dosage (mg/week) | −0.177 | −0.28–−0.075 | 0.001 | |
Leflunomide Dosage (mg/day) | −0.25 | −0.38–−0.11 | 0.001 | |
Anti-Malarials Dosage (mg/day) | −0.006 | −0.12–0.001 | 0.053 | |
Sulphasalazine Dosage (mg/day) | −0.003 | −0.005–−0.001 | 0.010 | |
Anti-TNF (YES/NO) | −4.97 | −8,48–−1.48 | 0.005 | |
Rituximab (YES/NO) | −9.75 | −20.31–0.81 | 0.070 |
Independent Variable | β Coefficient | 95%CI | p Value | |
---|---|---|---|---|
Smoking | Never | Reference category | ||
Former smoker | 4.11 | −0.73–8.95 | 0.096 | |
Smoker | 8.98 | 4.21–13.75 | 0.000 | |
Disease activity (DAS28) | Remission | Reference category | ||
Mild | 0.69 | −1.56–2.94 | 0.547 | |
Moderate | 2.76 | 0.85–4.66 | 0.005 | |
High | 3.70 | 1.14–6.25 | 0,005 | |
Corticosteroids (mg/day) | −0.13 | −0.27–0.01 | 0.079 | |
Methotrexate Dosage (mg/week) | −0.17 | −0.28–−0.07 | 0.001 | |
Leflunomide Dosage (mg/day) | −0.22 | −0.36–−0.08 | 0.002 | |
Anti-Malarials Dosage (mg/day) | −0.005 | −0.11–0.0008 | 0.087 | |
Sulphasalazine Dosage (mg/day) | −0.003 | −0.005–−0.0005 | 0.014 | |
Anti-TNF (YES/NO) | −5.20 | −8.57–−1.84 | 0.002 | |
Rituximab (YES/NO) | −10.37 | −20.68–−0.06 | 0.049 |
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Uriarte Ecenarro, M.; Useros, D.; Alfranca, A.; Tejedor, R.; González-Alvaro, I.; García-Vicuña, R. Anti-Citrullinated Protein Antibody Titers Are Independently Modulated by Both Disease Activity and Conventional or Biologic Anti-Rheumatic Drugs. Diagnostics 2022, 12, 1773. https://doi.org/10.3390/diagnostics12071773
Uriarte Ecenarro M, Useros D, Alfranca A, Tejedor R, González-Alvaro I, García-Vicuña R. Anti-Citrullinated Protein Antibody Titers Are Independently Modulated by Both Disease Activity and Conventional or Biologic Anti-Rheumatic Drugs. Diagnostics. 2022; 12(7):1773. https://doi.org/10.3390/diagnostics12071773
Chicago/Turabian StyleUriarte Ecenarro, Miren, Daniel Useros, Aranzazu Alfranca, Reyes Tejedor, Isidoro González-Alvaro, and Rosario García-Vicuña. 2022. "Anti-Citrullinated Protein Antibody Titers Are Independently Modulated by Both Disease Activity and Conventional or Biologic Anti-Rheumatic Drugs" Diagnostics 12, no. 7: 1773. https://doi.org/10.3390/diagnostics12071773