Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


The Clinical Implication of Anti-Cyclic Citrullinated Peptide Antibody in Late Onset Rheumatoid Arthritis.

Jung3,  Se Jin, Kang3,  Yoon, Ha3,  You-Jung, Lee3,  Kwang-Hoon, Lee3,  Sang Won, Park1,  Min-Chan, Lee2,  Soo Kon

Gangnam Severance Hospital, Seoul, Korea, Republic of
Yonsei Univ College of Med, Seoul, Korea, Republic of
Yonsei Univ College of Med

Background:

Late onset rheumatoid arthritis (LORA), onset of which is over 60 years old, has clinical features that are different from those of younger onset rheumatoid arthritis (YORA). While anti-cyclic citrullinated peptide antibody (anti-CCP) is known to be more disease-specific in RA, clinical implications of anti-CCP in LORA have not been reported to date.

Purpose:

To investigate the association of anti-CCP and its titer with markers reflecting disease-activity of RA.

Methods:

We retrospectively investigated medical records of 238 patients with RA, who visited Severance Hospital between January 2005 and May 2009. All patients were divided into two groups according to the age of 60 when they were diagnosed with RA (LORA (N=61) and YORA (N=177)). Rheumatic factor (RF) and anti-CCP were analyzed, and disease activity score (DAS) 28 at diagnosis was assessed at their first visit. Initial as well as accumulated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were measured. Accumulated levels were obtained using the area under curve (AUC) during the first year after diagnosis. Patients having anti-CCP were evenly distributed in three groups according to the range of the titer of anti-CCP (low (>5), moderate (5~135) and high (>270) titer groups).

Results:

The mean ages of patients with LORA and YORA were 67.1 ± 6.0 and 43.7 ± 10.5 years old, respectively. There were no significant differences in joint involvement, symptom duration, clinical manifestations, positivity of RF or anti-CCP, and medications between the two groups. However, patients with LORA had higher DAS28, anti-CCP titer and accumulated ESR and CRP levels than those with YORA. The titer of anti-CCP was well correlated with initial and accumulated levels of ESR in patients with LORA (r=0.416 and r=0.432, p<0.05), but not with patients with YORA.

Conclusions:

In patients with LORA, but not with YORA, the titer of anti-CCP was significantly correlated with initial and accumulated levels of ESR, suggesting that initial titer of anti-CCP might be used as a value to predict the extent of inflammation during the first year after diagnosis in LORA patients.

To cite this abstract, please use the following information:
Jung, Se Jin, Kang, Yoon, Ha, You-Jung, Lee, Kwang-Hoon, Lee, Sang Won, Park, Min-Chan, et al; The Clinical Implication of Anti-Cyclic Citrullinated Peptide Antibody in Late Onset Rheumatoid Arthritis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1061
DOI: 10.1002/art.28828

Abstract Supplement

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