Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Are High Titers of Anti-CCP Antibodies in Psoriatic Arthritis Patients a Biomarker of Erosive Disease?
Garcia-Valladares1, Ignacio, Cuchacovich1, Raquel, Iglesias-Gamarra2, Antonio A., Espinoza1, Luis R.
The presence of positive anti-CCP antibodies (anti-CCP), especially at high titers, is characteristic of rheumatoid arthritis (RA) and predictive of the development of erosive disease. In contrast, anti-CCP antibodies may be present in PsA in less than <15% and usually at low titers.
The aim of this study was to compare the clinical, serological and radiologic characteristics of PsA patients with and without anti-CCP antibodies.
Serum anti-CCP antibodies were measured in 80 patients with PsA. Age, gender, family history, means disease duration, pattern of joint involvement, nail and skin involvement, and treatment were obtained. CASPAR criteria were used.
Of the 80 patients with PsA, 38 were women and 42 men. The mean age 45.7-yrs (3972), and the mean disease duration was 9.4-yrs (214). Anti-CCP antibodies were present in 10 patients, mean titer 174.9 IU. Most patients were female (9/1), had polyarticular involvement, and erosive disease. In contrast to anti-CCP negative PsA patients, PsA patients with positive CCP antibodies were older 53.2 yrs vs 47.7-yrs, exhibited more RA-like polyarthritis, 8/10 (80%) vs 12/65 (18.4%), less nail involvement 4/10 (40%) vs 57/65 (87.6%), and less psoriatic spondyloarthropathy 0/10 vs 5/65 (7.7%). Anti-CCP negative PsA patients had predominant oligoarticular involvement 44/65 (67.7%) vs 2/10 (20%). Presence of enthesitis/dactylitis and PASI scores were similar in both groups. Rheumatoid factor was present in higher frequency in anti-CCP positive PsA patients, 4/10 (40%) vs 4/70 (5.7%), and anti-TNF-m was given to 5/10 (50%) of anti-CCP antibodies positive patients as compared to 28.5% in negative anti-CCP antibodies PsA patients.
The clinical distinction between RA and PsA is often difficult to establish. Positivity for RF and anti-CCP antibodies is highly sensitive and to certain extent specific markers and can pre-date the onset of RA. Others and we however, have described the presence, albeit in low frequency (515%), of anti-CCP antibodies in patients with PsA but not in psoriasis.
These findings clearly demonstrate that a subset of PsA patients with positivity for anti-CCP is highly associated with RA-like polyarticular involvement, erosive changes and possibly a more severe progression of disease, and also higher use of anti-TNF-m therapy; which lend support to the notion that anti-CCP antibodies should be considered a marker of disease severity in patients with PsA. Further studies, however, in larger number of patients are needed to define the role of these antibodies in PsA.
To cite this abstract, please use the following information:
Garcia-Valladares, Ignacio, Cuchacovich, Raquel, Iglesias-Gamarra, Antonio A., Espinoza, Luis R.; Are High Titers of Anti-CCP Antibodies in Psoriatic Arthritis Patients a Biomarker of Erosive Disease? [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1313