Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria - Hospital Clínico Universitario de Santiago (IDIS), 15706, Santiago de Compostela, Spain.
Rheumatology Department, Instituto de Investigación Hospital Universitario la Paz (IDIPAZ), 28046, Madrid, Spain.
Sci Rep. 2021 May 11;11(1):9945. doi: 10.1038/s41598-021-89502-y.
The initial management of rheumatoid arthritis (RA) has a high impact on disease prognosis. Therefore, we need to select the most appropriate treatment as soon as possible. This goal requires biomarkers of disease severity and prognosis. One such biomarker may be the presence of anti-carbamylated protein antibodies (ACarPA) because it is associated with adverse long term outcomes as radiographic damage and mortality. Here, we have assessed the ACarPA as short-term prognostic biomarkers. The study was conducted in 978 prospective early arthritis (EA) patients that were followed for two years. Our results show the association of ACarPA with increased levels of all the disease activity measures in the first visit after arthritis onset. However, the associations were more significant with the high levels in local measures of inflammation and physician assessment than with the increases in systemic inflammation and patient-reported outcomes. More notably, disease activity was persistently increased in the ACarPA positive patients during the two years of follow-up. These differences were significant even after accounting for the presence of other RA autoantibodies. Therefore, the ACarPA could be considered short-term prognostic biomarkers of increased disease activity in the EA patients.
类风湿关节炎（RA）的初始治疗对疾病预后有重大影响。因此，我们需要尽快选择最合适的治疗方法。这一目标需要疾病严重程度和预后的生物标志物。一种这样的生物标志物可能是存在抗氨甲酰化蛋白抗体（ACarPA），因为它与不良的长期结果有关，如放射学损伤和死亡率。在这里，我们评估了 ACarPA 作为短期预后生物标志物。这项研究在 978 名前瞻性早期关节炎（EA）患者中进行，这些患者随访了两年。我们的结果表明，ACarPA 与关节炎发作后首次就诊时所有疾病活动度指标的升高有关。然而，与全身性炎症和患者报告的结果相比，ACarPA 与局部炎症和医生评估的高指标更显著相关。更值得注意的是，在两年的随访期间，ACarPA 阳性患者的疾病活动度持续升高。即使考虑到其他 RA 自身抗体的存在，这些差异仍然具有统计学意义。因此，ACarPA 可被视为 EA 患者疾病活动度增加的短期预后生物标志物。
