Different clinical relevance of anti-citrullinated proteins antibodies in RA patients

Objective – to find a potential relationship between ACPA and disease activity, bone destruction, and ACPAs responses to various therapeutic regimens.

Materials and methods. The study included 232 patients with rheumatoid arthritis (RA); 90 patients had early RA; 142 patients had advanced stage of the disease.

Results. 77 (85.6%) patients with early RA were high positive for anti-CCP, and 29 (70.7%) patients – high positive for anti-MCV. A positive correlation was found between anti-MCV and DAS28 (r=0.4; p=0.04). As for advanced RA, 78 (80.4%) patients were high positive for anti-CCP, and 70 (79.5%) – for anti-MCV. There was a positive correlation between anti-MCV concentration and SDAI (r=0.4; p=0.02), as well as CDAI (r=0.4; p=0.02). No significant correlations were found between the anti-CCP levels and activity indices, anti-CCP and acute-phase parameters in both early and advanced RA groups. Higher total Sharp scores (96.5 (65.0–122.0)) were found in pts high positive for anti-MCV (n=79), compared to low-positive/negative (n=27) patients (57.0 (31.0–88.0); p<0.05). Anti-MCV levels dropped significantly in pts on rituximab and tocilizumab therapy at weeks 12 and 24 after initiation of treatment, while high anti-CCP concentration persisted throughout the treatment.

Conclusion. Anti-MCV levels correlated with inflammatory activity and development of bone destruction, and were decreasing in pts on treatment. Anti-CCP was less responsive, showed minor changes during treatment, therefore its’ thorough monitoring was not feasible.

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