Rheumatology Advance Access originally published online on May 18, 2005
Rheumatology 2005 44(8):1056-1060; doi:10.1093/rheumatology/keh686
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The clinical and genetic associations of anti-cyclic citrullinated peptide antibodies in psoriatic arthritis
Royal National Hospital for Rheumatic Diseases and 1 Bath Institute for Rheumatic Diseases, Bath, UK.
Correspondence to: N. McHugh, Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath BA1 1RL, UK. E-mail: Neil.McHugh{at}rnhrd-tr.swest.nhs.uk
Objectives. Antibodies recognizing a cyclic citrullinated peptide (anti-CCP) are highly specific for rheumatoid arthritis (RA) but their role in psoriatic arthritis (PsA) remains unclear. The aim of this study was therefore to investigate the prevalence of anti-CCP antibodies in PsA and assess their clinical and genetic associations.
Methods. One hundred and twenty-six patients with PsA, 40 patients with seropositive RA and 40 controls were tested for the presence of anti-CCP antibodies, rheumatoid factor (RF) and the HLA-DRB1 shared epitope. Clinical and radiological data were collected prospectively on all patients and compared between anti-CCP-positive and -negative patients.
Results. Seven (5.6%) patients with PsA were positive for anti-CCP antibodies compared with 0% of controls and 97% of patients with seropositive RA. The presence of anti-CCP antibodies in PsA was significantly associated with the HLA-DRB1 shared epitope (P<0.005), erosive disease (P<0.05), number of swollen joints (P<0.02) and DMARD use (P<0.05).
Conclusions. Overall, the increased prevalence of anti-CCP antibodies in this PsA population failed to reach statistical significance. However, when present, they were a marker of disease severity and had RA-linked MHC class II associations. Further studies are needed in a larger population of patients with PsA and appropriate controls to confirm any true association that may be present.
KEY WORDS: Psoriatic arthritis, Anti-citrullinated peptide antibodies, Shared epitope
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