Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria.
Ann Rheum Dis. 2013 Feb;72(2):241-4. doi: 10.1136/annrheumdis-2012-202297. Epub 2012 Oct 19.
To investigate changes of rheumatoid factor (RF) and antibodies against citrullinated peptides (ACPA) during therapy with disease modifying antirheumatic drugs.
We obtained clinical and serological data of patients from the treatment start and after 6 months of therapy. With non-parametric tests, we analysed changes of ACPA and RF levels between the two visits and the influence of treatment response. Furthermore, we analysed potential influential factors as disease chronicity, different therapeutics and the trend over 18 months.
143 ACPA and RF positive patients were included. The median (25th/75th percentile) relative changes after 6 months were -35.6% (-63.3; -8.3) for RF and -15.2% (-40.0; 10.0) for ACPA (p<0.001 for both). Changes of RF levels were significantly greater than those seen for ACPA (p<0.001). The decrease of ACPA and RF was significantly higher in treatment responders (p=0.034 and p=0.01, respectively). Aside from changes in disease activity, only a short disease duration showed an independent effect on changes of RF levels (p=0.087).
ACPA and RF levels decreased significantly after 6 months of therapy. Reductions of both autoantibodies were closely linked to a reduction of disease activity. RF declined faster, to a larger extent and in greater numbers of patients than ACPA.
研究疾病修正抗风湿药物治疗过程中类风湿因子（RF）和抗瓜氨酸肽抗体（ACPA）的变化。
我们从治疗开始和治疗 6 个月后获得了患者的临床和血清学数据。通过非参数检验，我们分析了两次就诊时 ACPA 和 RF 水平的变化以及治疗反应的影响。此外，我们还分析了疾病慢性、不同治疗方法和 18 个月期间的趋势等潜在影响因素。
共纳入 143 例 ACPA 和 RF 阳性患者。6 个月后 RF 的中位数（25 分位/75 分位）相对变化为 -35.6%（-63.3；-8.3），ACPA 为 -15.2%（-40.0；10.0）（均<0.001）。RF 水平的变化明显大于 ACPA（p<0.001）。治疗反应者的 ACPA 和 RF 下降更为显著（p=0.034 和 p=0.01）。除了疾病活动度的变化外，只有疾病持续时间较短对 RF 水平的变化有独立影响（p=0.087）。
治疗 6 个月后，ACPA 和 RF 水平明显下降。两种自身抗体的减少与疾病活动度的降低密切相关。RF 的下降速度更快、幅度更大、患者数量更多。
