ANTI-CYCLIC CITRULLINATED PEPTIDE ANTIBODY RELATED TO THE DISEASE PROGRESSION AND EXTRA- ARTICULAR INVOLVEMENT IN PATIENT WITH RHEUMATOID ARTHRITIS IN HOSPITAL UNIVERSITI SAINS MALAYSIA
Objective : Rheumatoid arthritis (RA) is a chronic debilitating inflammatory disease affecting mainly the joint and surrounding tissue, and also other organs in the body. Other than rheumatoid factor, anti-cyclic citrullinate peptide (anti-CCP) antibody is another biomarker that can be used to diagnose RA. The objective of this study was to evaluate the significant of anti-CCP antibody in predicting disease activity and progression in term of radiological and extra articular manifestation upon diagnosis in patient with RA in HUSM.
Methods : This was a cross sectional study with retrospective record review. A total of 159 patients who were diagnosed as RA in HUSM based on 2010 EULAR criteria for RA since 2010 until 2017 were included in this study. Exclusion criteria include age of 16 years old or less at the onset of diagnosis, probable RA, and overlap syndromes. The data was retrieved from medical record for rheumatoid factor, anti-CCP antibody, assessment of disease activity using DAS28 ESR calculator, plain radiograph of hands or feet, and extra-articular manifestation in term of assessment of rheumatoid nodule, pulmonary involvement, Felty syndrome, vasculitis and anemia upon diagnosis.
Results : The prevalence of anti-CCP antibody was 52.2%. Patients with positive anti- CCP antibody who had positive rheumatoid factor was significantly higher than other groups (n=83; 73.5%). For radiological involvement, it was significantly higher in anti- CCP antibody positive group (n=83; 48.2%). However, there was no significant difference in mean and classes of disease activity score, and extra-articular manifestations between different anti-CCP antibody positivity groups. Extra-articular manifestations was not associated with high disease activity upon diagnosis of RA.
Conclusion : This study proved a prognostic utility of anti-CCP for rheumatoid factor and radiological outcomes, however no significance in disease activity and extra-articular manifestation upon diagnosis in patient with RA in HUSM.