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Rheumatoid arthritis phenotype at presentation differs depending on the number of autoantibodies present

Derksen, V. F A M; Ajeganova, S.; Trouw, L. A. LU ; van der Helm-van Mil, A. H M; Hafström, I.; Huizinga, T. W J; Toes, R. E M; Svensson, B. LU and van der Woude, D. (2017) In Annals of the Rheumatic Diseases 76. p.716-720
Abstract

Objectives In rheumatoid arthritis (RA), seropositive and seronegative disease may be two entities with different underlying pathophysiological mechanisms, long-term outcomes and disease presentations. However, the effect of the conjoint presence of multiple autoantibodies, as proxy for a more pronounced humoral autoimmune response, on clinical phenotype remains unclear. Therefore, this study investigates the association between the number of autoantibodies and initial clinical presentation in two independent cohorts of patients with early RA. Methods Autoantibody status (rheumatoid factor, anticitrullinated protein antibodies and anticarbamylated protein antibodies) was determined at baseline in the Leiden Early Arthritis Cohort... (More)

Objectives In rheumatoid arthritis (RA), seropositive and seronegative disease may be two entities with different underlying pathophysiological mechanisms, long-term outcomes and disease presentations. However, the effect of the conjoint presence of multiple autoantibodies, as proxy for a more pronounced humoral autoimmune response, on clinical phenotype remains unclear. Therefore, this study investigates the association between the number of autoantibodies and initial clinical presentation in two independent cohorts of patients with early RA. Methods Autoantibody status (rheumatoid factor, anticitrullinated protein antibodies and anticarbamylated protein antibodies) was determined at baseline in the Leiden Early Arthritis Cohort (n=828) and the Swedish BARFOT (Better Anti-Rheumatic Farmaco-Therapy, n=802) study. The association between the number of autoantibodies and baseline clinical characteristics was investigated using univariable and multivariable ordinal regression. Results In both cohorts, the following independent associations were found in multivariable analysis: patients with a higher number of RA-associated antibodies were younger, more often smokers, had a longer symptom duration and a higher erythrocyte sedimentation rate at presentation compared with patients with few autoantibodies. Conclusions The number of autoantibodies, reflecting the breadth of the humoral autoimmune response, is associated with the clinical presentation of RA. Predisease pathophysiology is thus reflected by the initial clinical phenotype.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of the Rheumatic Diseases
volume
76
pages
716 - 720
publisher
British Medical Association
external identifiers
  • scopus:84995488402
  • wos:000396856100017
ISSN
0003-4967
DOI
10.1136/annrheumdis-2016-209794
language
English
LU publication?
yes
id
20430540-e207-4cae-90ae-c550adb99974
date added to LUP
2016-12-05 08:54:40
date last changed
2018-01-07 11:38:38
@article{20430540-e207-4cae-90ae-c550adb99974,
  abstract     = {<p>Objectives In rheumatoid arthritis (RA), seropositive and seronegative disease may be two entities with different underlying pathophysiological mechanisms, long-term outcomes and disease presentations. However, the effect of the conjoint presence of multiple autoantibodies, as proxy for a more pronounced humoral autoimmune response, on clinical phenotype remains unclear. Therefore, this study investigates the association between the number of autoantibodies and initial clinical presentation in two independent cohorts of patients with early RA. Methods Autoantibody status (rheumatoid factor, anticitrullinated protein antibodies and anticarbamylated protein antibodies) was determined at baseline in the Leiden Early Arthritis Cohort (n=828) and the Swedish BARFOT (Better Anti-Rheumatic Farmaco-Therapy, n=802) study. The association between the number of autoantibodies and baseline clinical characteristics was investigated using univariable and multivariable ordinal regression. Results In both cohorts, the following independent associations were found in multivariable analysis: patients with a higher number of RA-associated antibodies were younger, more often smokers, had a longer symptom duration and a higher erythrocyte sedimentation rate at presentation compared with patients with few autoantibodies. Conclusions The number of autoantibodies, reflecting the breadth of the humoral autoimmune response, is associated with the clinical presentation of RA. Predisease pathophysiology is thus reflected by the initial clinical phenotype.</p>},
  author       = {Derksen, V. F A M and Ajeganova, S. and Trouw, L. A. and van der Helm-van Mil, A. H M and Hafström, I. and Huizinga, T. W J and Toes, R. E M and Svensson, B. and van der Woude, D.},
  issn         = {0003-4967},
  language     = {eng},
  pages        = {716--720},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {Rheumatoid arthritis phenotype at presentation differs depending on the number of autoantibodies present},
  url          = {http://dx.doi.org/10.1136/annrheumdis-2016-209794},
  volume       = {76},
  year         = {2017},
}