Stropuvienė Sigita, Baranauskaitė Asta, Bukauskienė Loreta, Zaikauskienė Jolanta
Clinic of Rheumatology, Traumatology Orthopaedics, and Reconstructive Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania.
Acta Med Litu. 2018;25(2):112-123. doi: 10.6001/actamedica.v25i2.3765.
To provide data on the use of anti-cyclic citrullinated peptide antibody (anti-CCP) and other routinely used clinical parameters and to assess the impact of anti-CCP status on therapeutic decisions, an observational study was conducted in patients with rheumatoid arthritis (RA).
Sixty-seven adult patients with a recent diagnosis of RA were recruited from four rheumatology centres in Lithuania and were prospectively observed for 12 months. Data collection was based on the review of medical records and routine examination of patients. Patients completed the Health Assessment Questionnaire - Disability Index and Patient Global Assessment of disease activity using a visual analogue scale. Physicians were asked about the importance of the anti-CCP results and other factors important for therapeutic decisions.
Of the 67 patients enrolled, 54 (80.6%) completed the study. At the beginning of the study, physicians considered anti-CCP results to be important for decision-making in 87.0% of patients. The perceived importance of anti-CCP results did not change significantly throughout the study. After one year of treatment, factors that were considered more important than the anti-CCP results included the presence of erosions, significantly increased C-reactive protein, duration of morning stiffness, multi-articular expanding, and rheumatoid factor status. For nearly half of the patients ( = 26; 48.1%), physicians would not change the treatment strategy if the patient had the opposite anti-CCP results at baseline.
The study revealed that decision-making in the management of RA was based on multifactorial data. The role of anti-CCP as a single test in treatment decisions needs further investigation.
为了提供有关抗环瓜氨酸肽抗体（抗CCP）及其他常用临床参数的使用数据，并评估抗CCP状态对治疗决策的影响，对类风湿关节炎（RA）患者进行了一项观察性研究。
从立陶宛的四个风湿病中心招募了67例近期诊断为RA的成年患者，并对其进行了为期12个月的前瞻性观察。数据收集基于病历回顾和患者的常规检查。患者使用视觉模拟量表完成了健康评估问卷-残疾指数和患者对疾病活动的整体评估。询问医生抗CCP结果的重要性以及对治疗决策重要的其他因素。
在入组的67例患者中，54例（80.6%）完成了研究。在研究开始时，87.0%的患者医生认为抗CCP结果对决策很重要。在整个研究过程中，抗CCP结果的感知重要性没有显著变化。治疗一年后，被认为比抗CCP结果更重要的因素包括存在侵蚀、C反应蛋白显著升高、晨僵持续时间、多关节扩展和类风湿因子状态。对于近一半的患者（n = 26；48.1%），如果患者在基线时抗CCP结果相反，医生不会改变治疗策略。
该研究表明，RA管理中的决策基于多因素数据。抗CCP作为单一检测在治疗决策中的作用需要进一步研究。
