Anti-cyclic citrullinated peptide antibody predicts the development of rheumatoid arthritis in patients with undifferentiated arthritis  

作　　者：Chun Li Yan Zhang Hui Song Jie Gao Dong-Bao Zhao Qi Zhu Dong-Yi He Li Wang Xiang-Pei Li Xu-Dong Liu Wei-Guo Xiao Xin-Yu Wu Hua-Xiang Wu Wei Tu Shao-Xian Hu Xin Wang Zhi-Jun Li Zhi-Min Lu Zhan-Yun Da Bo Liang Xiao-Min Liu Jin-Wei Zhao Ling Li Feng Han Wu-Fang Qi Wei Wei Xu Ma Zhen-Bin Li Gui-Min Zheng Feng-Xiao Zhang Yi Li You-Lian Wang Guang-Hui Ling Jin-Wei Chen Xiao-Qiang Hou Jing Zhang Qing-Ping Chen Chang-Lian Liu Yan Zhang Jia-Shun Zeng Qing-Hua Zou Yong-Fei Fang Yin Su Zhan-Guo Li 

机构地区：[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 Cent

出　　处：《Chinese Medical Journal》2019年第24期2899-2904,共6页中华医学杂志（英文版）

基　　金：The study was supported by the grants from the Ministry of Science and Technology of China(No.2008BAI59800 and 2014BAI07B01);the National Natural Science Foundation of China(No.81671609);Beijing Municipal Science and Technology Project(No.Z171100000417007).

摘　　要：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%,χ^2=8.228,P=0.008),anti-cyclic citrullinated peptide(CCP)antibodypositivity(66.7%vs.10.7%,χ^2=43.897,P<0.001),and double-positivity rate of RF and anti-CCP antibody(38.1%vs.4.1%,χ^2=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.

关 键 词：Anti-cyclic citrullinated PEPTIDE ANTIBODY Arthritis Rheumatoid RHEUMATOID factor UNDIFFERENTIATED ARTHRITIS 

分 类 号：R59[医药卫生—内科学]