MRI-detected osteitis is not associated with the presence or level of ACPA alone, but with the combined presence of ACPA and RFReportar como inadecuado

MRI-detected osteitis is not associated with the presence or level of ACPA alone, but with the combined presence of ACPA and RF - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Arthritis Research and Therapy

, 18:179

First Online: 02 August 2016Received: 13 May 2016Accepted: 14 July 2016


BackgroundIn rheumatoid arthritis RA bone marrow edema BME, osteitis and anti-citrullinated protein antibodies ACPA are associated with radiographic progression. ACPA have been associated with BME, but it is unknown if this association is confined to ACPA and BME. We performed cross-sectional analysis of the association of ACPA, rheumatoid factor RF and anti-carbamylated protein anti-CarP antibodies with BME and other types of inflammation synovitis, tenosynovitis detected by magnetic resonance imaging MRI.

MethodsDisease-modifying antirheumatic drug DMARD-naïve patients with early arthritis n = 589, included in the Leiden Early Arthritis Clinic cohort, underwent contrast-enhanced 1.5 T MRI of unilateral wrist, metacarpophalangeal and metatarsophalangeal-joints at baseline. BME, synovitis and tenosynovitis were scored by two readers. ACPA, rheumatoid factor RF and anti-CarP were determined at baseline.

ResultsIn univariable analyses ACPA-positive patients had higher BME scores than ACPA-negative patients median 4.5 vs. 2.0, p < 0.001, but not more synovitis and tenosynovitis. Also RF median 3.75 vs. 2.0, p < 0.001 and anti-CarP antibodies median 3.5 vs. 2.5, p = 0.012 were associated with higher BME scores. Because the autoantibodies were concomitantly present, analyses were stratified for the presence of different autoantibody combinations. ACPA-positive ACPA+, RF-negative RF-, anti-CarP-negative anti-CarP- patients did not have higher BME-scores than ACPA-negative ACPA-, RF-, anti-CarP- patients. However ACPA+, RF-positive RF+, anti-CarP- patients and ACPA+, RF+, anti-CarP-positive anti-CarP+ patients had higher BME scores than ACPA-, RF-, anti-CarP- patients median 5.0 and 4.5 vs. 2.0, p < 0.001 and p < 0.001. ACPA levels were not associated with BME scores. Analyses within RA- and UA-patients revealed similar results.

ConclusionsThe presence of ACPA alone or ACPA level was not statistically significantly associated with BME scores, but the combined presence of ACPA and RF was associated with more BME. This suggests an additive role of RF to ACPA in mediating osteitis.

KeywordsRheumatoid arthritis ACPA RF MRI Bone marrow edema Electronic supplementary materialThe online version of this article doi:10.1186-s13075-016-1076-0 contains supplementary material, which is available to authorized users.

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Autor: Debbie M. Boeters - Wouter P. Nieuwenhuis - Marije K. Verheul - Elize C. Newsum - Monique Reijnierse - René E. M. Toe


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