Abstract

Background:

Clinical outcomes of undifferentiated arthritis (UA) are diverse, and only 40% of patients with UA develop rheumatoid arthritis (RA) after 3 years. Discovering predictive markers at disease onset for further intervention is critical. Therefore, our objective was to analyze the clinical outcomes of UA and ascertain the predictors for RA development.

Methods:

We performed a prospective, multi-center study from January 2013 to October 2016 among Chinese patients diagnosed with UA in 22 tertiary-care hospitals. Clinical and serological parameters were obtained at recruitment. Follow-up was undertaken in all patients every 12 weeks for 2 years. Predictive factors of disease progression were identified using multivariate Cox proportional hazards regression.

Results:

A total of 234 patients were recruited in this study, and 17 (7.3%) patients failed to follow up during the study. Among the 217 patients who completed the study, 83 (38.2%) patients went into remission. UA patients who developed RA had a higher rheumatoid factor (RF)-positivity (42.9% vs. 16.8%, χ2 = 8.228, P = 0.008), anti-cyclic citrullinated peptide (CCP) antibody-positivity (66.7% vs. 10.7%, χ2 = 43.897, P < 0.001), and double-positivity rate of RF and anti-CCP antibody (38.1% vs. 4.1%, χ2 = 32.131, P < 0.001) than those who did not. Anti-CCP antibody but not RF was an independent predictor for RA development (hazard ratio 18.017, 95% confidence interval: 5.803–55.938; P < 0.001).

Conclusion:

As an independent predictor of RA, anti-CCP antibody should be tested at disease onset in all patients with UA.

Details

Title
Anti-cyclic citrullinated peptide antibody predicts the development of rheumatoid arthritis in patients with undifferentiated arthritis
Author
Li, Chun 1 ; Zhang, Yan 2 ; Song, Hui 2 ; Gao, Jie 3 ; Dong-Bao, Zhao 3 ; Zhu, Qi 4 ; Dong-Yi, He 4 ; Wang, Li 5 ; Xiang-Pei, Li 5 ; Xu-Dong, Liu 6 ; Wei-Guo, Xiao 6 ; Xin-Yu, Wu 7 ; Hua-Xiang, Wu 7 ; Tu, Wei 8 ; Shao-Xian, Hu 8 ; Wang, Xin 9 ; Li, Zhi-Jun 9 ; Zhi-Min, Lu 10 ; Zhan-Yun, Da 10 ; Liang, Bo 11 ; Xiao-Min, Liu 11 ; Jin-Wei, Zhao 12 ; Li, Ling 12 ; Han, Feng 13 ; Wu-Fang, Qi 13 ; Wei, Wei 14 ; Xu, Ma 15 ; Zhen-Bin, Li 15 ; Gui-Min, Zheng 16 ; Feng-Xiao, Zhang 16 ; Li, Yi 17 ; You-Lian, Wang 17 ; Guang-Hui, Ling 18 ; Jin-Wei, Chen 18 ; Xiao-Qiang, Hou 19 ; Zhang, Jing 20 ; Chen, Qing-Ping 20 ; Chang-Lian, Liu 21 ; Jia-Shun, Zeng 22 ; Qing-Hua, Zou 23 ; Yong-Fei, Fang 23 ; Yin, Su 1 ; Zhan-Guo, Li 1 

1  Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China 
2  Department of Rheumatology and Immunology, Beijing Jishuitan Hospital, Beijing 100035, China 
3  Department of Rheumatology and Immunology, Changhai Hospital, Shanghai 200433, China 
4  Department of Rheumatology, Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 200052, China 
5  Department of Rheumatology and Immunology, Anhui Provincial Hospital, Hefei, Anhui 230001, China 
6  Department of Rheumatology and Immunology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China 
7  Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China 
8  Department of Rheumatology and Immunology, Tongji Hospital, Wuhan, Hubei 430030, China 
9  Department of Rheumatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China 
10  Department of Rheumatology and Immunology, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China 
11  Department of Rheumatology and Immunology, The Hospital of Shunyi District Beijing, Beijing 101300, China 
12  Department of Infection and Immunology, Tianjin Union Medical Center, Tianjin 300121, China 
13  Department of Rheumatology and Immunology, Tianjin First Central Hospital, Tianjin 300192, China 
14  Department of Rheumatology and Immunology, Tianjin Medical University General Hospital, Tianjin 300052, China 
15  Department of Rheumatology and Immunology, Peace Hospital, Shijiazhuang, Hebei 050000, China 
16  Department of Rheumatology and Immunology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China 
17  Department of Rheumatology, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi 330006, China 
18  Division of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China 
19  Department of Rheumatology and Immunology, The First College of Clinical Medical Science of China Three Gorges University & Yichang Central People's Hospital, Yichang, Hubei 443003, China 
20  Department of Rheumatology and Immunology I Wald, Xi’an No. 5 Hospital, Xi’an, Shaanxi 710082, China 
21  Department of Rheumatology and Immunology V Wald, Xi’an No. 5 Hospital, Xi’an, Shaanxi 710082, China 
22  Department of Nephrology and Rheumatology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, China 
23  Department of Rheumatology, The First Hospital Affiliated to AMU (Southwest Hospital), Chongqing 400038, China 
Pages
2899-2904
Section
Original Articles
Publication year
2019
Publication date
Dec 2019
Publisher
Lippincott Williams & Wilkins Ovid Technologies
ISSN
03666999
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1097/CM9.0000000000000570
ProQuest document ID
2502605722
Copyright
Copyright © 2019 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0 (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.