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Rheumatology Advance Access published online on May 18, 2005
Rheumatology, doi:10.1093/rheumatology/keh686
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received January 19, 2005
Accepted April 12, 2005

Original Papers

The clinical and genetic associations of anti-cyclic citrullinated peptide antibodies in psoriatic arthritis

E. Korendowych 1, P. Owen 2, J. Ravindran 1, C. Carmichael 2, and N. McHugh 1*

1 Royal National Hospital for Rheumatic Diseases
2 Bath Institute for Rheumatic Diseases, Bath, UK

* To whom correspondence should be addressed.
N. McHugh, E-mail: Neil.McHugh{at}rnhrd-tr.swest.nhs.uk


  Abstract

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.

Keywords: Psoriatic arthritis; Anti-citrullinated peptide antibodies; Shared epitope.
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