TY - JOUR
T1 - Anti-citrullinated peptide antibodies are the strongest predictor of clinically relevant radiographic progression in rheumatoid arthritis patients achieving remission or low disease activity
T2 - A post hoc analysis of a nationwide cohort in Japan
AU - the Japanese RA Patients with RRP Study Group
AU - Koga, Tomohiro
AU - Okada, Akitomo
AU - Fukuda, Takaaki
AU - Hidaka, Toshihiko
AU - Ishii, Tomonori
AU - Ueki, Yukitaka
AU - Kodera, Takao
AU - Nakashima, Munetoshi
AU - Takahashi, Yuichi
AU - Honda, Seiyo
AU - Horai, Yoshiro
AU - Watanabe, Ryu
AU - Okuno, Hiroshi
AU - Aramaki, Toshiyuki
AU - Izumiyama, Tomomasa
AU - Takai, Osamu
AU - Miyashita, Taiichiro
AU - Sato, Shuntaro
AU - Kawashiri, Shin Ya
AU - Iwamoto, Naoki
AU - Ichinose, Kunihiro
AU - Tamai, Mami
AU - Origuchi, Tomoki
AU - Nakamura, Hideki
AU - Aoyagi, Kiyoshi
AU - Eguchi, Katsumi
AU - Hirabayashi, Yasuhiko
AU - Matsuda, Takemasa
AU - Tsukada, Toshiaki
AU - Tsukano, Michishi
AU - Rikimaru, Akira
AU - Ida, Hiroaki
AU - Matsuoka, Naoki
AU - Kawakami, Atsushi
AU - Suematsu, Eiichi
AU - Migita, Kiyoshi
AU - Kawabe, Youjirou
AU - Oribe, Motohiro
AU - Sekiguchi, Yukio
AU - Munakata, Yasuhiko
AU - Mine, Masanobu
AU - Hatayama, Akira
AU - Ogura, Ken
N1 - Publisher Copyright:
© 2017 Koga et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2017/5
Y1 - 2017/5
N2 - Objectives: To determine prognostic factors of clinically relevant radiographic progression (CRRP) in patients with rheumatoid arthritis (RA) achieving remission or low disease activity (LDA) in clinical practice. Methods: Using data from a nationwide, multicenter, prospective study in Japan, we evaluated 198 biological disease-modifying antirheumatic drug (bDMARD)-naïve RA patients who were in remission or had LDA at study entry after being treated with conventional synthetic DMARDs (csDMARDs). CRRP was defined as the yearly progression of modified total Sharp score (mTSS) >3.0 U. We performed a multiple logistic regression analysis to explore the factors to predict CRRP at 1 year. We used receiver operating characteristic (ROC) curve to estimate the performance of relevant variables for predicting CRRP. Results: The mean Disease Activity Score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR) was 2.32-0.58 at study entry. During the 1-year observation, remission or LDA persisted in 72% of the patients. CRRP was observed in 7.6% of the patients. The multiple logistic regression analysis revealed that the independent variables to predict the development of CRRP were: anti-citrullinated peptide antibodies (ACPA) positivity at baseline (OR = 15.2, 95%CI 2.64-299), time-integrated DAS28-ESR during the 1 year post-baseline (7.85-unit increase, OR = 1.83, 95%CI 1.03-3.45), and the mTSS at baseline (13-unit increase, OR = 1.22, 95% CI 1.06-1.42). Conclusions: ACPA positivity was the strongest independent predictor of CRRP in patients with RA in remission or LDA. Physicians should recognize ACPA as a poor-prognosis factor regarding the radiographic outcome of RA, even among patients showing a clinically favorable response to DMARDs.
AB - Objectives: To determine prognostic factors of clinically relevant radiographic progression (CRRP) in patients with rheumatoid arthritis (RA) achieving remission or low disease activity (LDA) in clinical practice. Methods: Using data from a nationwide, multicenter, prospective study in Japan, we evaluated 198 biological disease-modifying antirheumatic drug (bDMARD)-naïve RA patients who were in remission or had LDA at study entry after being treated with conventional synthetic DMARDs (csDMARDs). CRRP was defined as the yearly progression of modified total Sharp score (mTSS) >3.0 U. We performed a multiple logistic regression analysis to explore the factors to predict CRRP at 1 year. We used receiver operating characteristic (ROC) curve to estimate the performance of relevant variables for predicting CRRP. Results: The mean Disease Activity Score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR) was 2.32-0.58 at study entry. During the 1-year observation, remission or LDA persisted in 72% of the patients. CRRP was observed in 7.6% of the patients. The multiple logistic regression analysis revealed that the independent variables to predict the development of CRRP were: anti-citrullinated peptide antibodies (ACPA) positivity at baseline (OR = 15.2, 95%CI 2.64-299), time-integrated DAS28-ESR during the 1 year post-baseline (7.85-unit increase, OR = 1.83, 95%CI 1.03-3.45), and the mTSS at baseline (13-unit increase, OR = 1.22, 95% CI 1.06-1.42). Conclusions: ACPA positivity was the strongest independent predictor of CRRP in patients with RA in remission or LDA. Physicians should recognize ACPA as a poor-prognosis factor regarding the radiographic outcome of RA, even among patients showing a clinically favorable response to DMARDs.
UR - http://www.scopus.com/inward/record.url?scp=85019463880&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019463880&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0175281
DO - 10.1371/journal.pone.0175281
M3 - Article
C2 - 28505163
AN - SCOPUS:85019463880
VL - 12
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 5
M1 - 0175281
ER -