8 research outputs found
RA development is associated with loss of hand bone mineral density in very early arthritis patients: Preliminary results from the Norwegian very early arthritis cohort
Should Anti-citrullinated Protein Antibody and Rheumatoid Factor Status Be Reassessed During the First Year of Followup in Recent-Onset Arthritis? A Longitudinal Study
Pathophysiology and treatment of rheumatic disease
SHOULD ACPA STATUS BE REASSESSED IN PATIENTS WITH EARLY ARTHRITIS: RESULTS FROM FOLLOW-UP EXAMINATIONS IN PATIENTS WITH ARTHRITIS OF LESS THAN 16 WEEKS DURATION
Pathophysiology and treatment of rheumatic disease
Role of erosions typical of rheumatoid arthritis in the 2010 ACR/EULAR rheumatoid arthritis classification criteria: results from a very early arthritis cohort
Pathophysiology and treatment of rheumatic disease
THE ROLE OF EROSIONS TYPICAL OF RHEUMATOID ARTHRITIS IN THE 2010 ACR/EULAR RHEUMATOID CLASSIFICATION CRITERIA: RESULTS FROM A VERY EARLY ARTHRITIS COHORT
Pathophysiology and treatment of rheumatic disease
IN RHEUMATOID ARTHRITIS, SMOKING IS NOT PRIMARILY ASSOCIATED WITH ANTI-CITRULLINAGED PROTEIN ANTIBODIES, BUT WITH THE PRESENCE OF SEVERAL AUTOANTIBODIES
Pathophysiology and treatment of rheumatic disease
Toward a data-driven evaluation of the 2010 American College of Rheumatology/European League Against Rheumatism criteria for rheumatoid arthritis: is it sensible to look at levels of rheumatoid factor?
OBJECTIVE Recently, new classification criteria for rheumatoid arthritis (RA) have been devised by methodology that used first a quantitative approach (data from databases), then a qualitative approach (consensus; based on paper patients), and finally a common sense-based approach (evaluation of the former phases). Now the individual items that make up these criteria are being evaluated. This study was undertaken to analyze the item "autoantibodies," in particular rheumatoid factor (RF) level. METHODS Three separate cohorts comprising a total of 972 patients with undifferentiated arthritis were studied for RA development (according to the 1987 American College of Rheumatology criteria) and arthritis persistence. The positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios (LRs) were compared between different levels of RF and the presence of anti-citrullinated protein antibody (ACPA). A similar comparison was made in 686 RA patients for the rate of joint destruction and achievement of sustained disease-modifying antirheumatic drug-free remission during 7 years of followup. The variation in RF levels obtained by different measurement methods in the same RF-positive sera was explored. RESULTS Compared to high RF levels, presence of ACPA had a better balance between positive LR and negative LR and between PPV and NPV for RA development. The additive value of ACPA assessment after testing for RF level was higher than vice versa. The association between high RF level and RA severity was not as strong as that between ACPA antibodies and RA severity. The RF level obtained by different methods in the same patients' sera varied considerably. CONCLUSION Our findings indicate that determination of RF level is subject to large variation; high RF level has limited additive prognostic value compared to ACPA positivity. Thus, omitting RF level and using RF presence, ACPA presence, and ACPA level may improve the 2010 criteria for RA.Pathophysiology and treatment of rheumatic disease
Toward a Data-Driven Evaluation of the 2010 American College of Rheumatology/European League Against Rheumatism Criteria for Rheumatoid Arthritis Is It Sensible to Look at Levels of Rheumatoid Factor?
Objective. Recently, new classification criteria for rheumatoid arthritis (RA) have been devised by methodology that used first a quantitative approach (data from databases), then a qualitative approach (consensus; based on paper patients), and finally a common sense-based approach (evaluation of the former phases). Now the individual items that make up these criteria are being evaluated. This study was undertaken to analyze the item "autoantibodies," in particular rheumatoid factor (RF) level.
Methods. Three separate cohorts comprising a total of 972 patients with undifferentiated arthritis were studied for RA development (according to the 1987 American College of Rheumatology criteria) and arthritis persistence. The positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios (LRs) were compared between different levels of RF and the presence of anti-citrullinated protein antibody (ACPA). A similar comparison was made in 686 RA patients for the rate of joint destruction and achievement of sustained disease-modifying antirheumatic drug-free remission during 7 years of followup. The variation in RF levels obtained by different measurement methods in the same RF-positive sera was explored.
Results. Compared to high RF levels, presence of ACPA had a better balance between positive LR and negative LR and between PPV and NPV for RA development. The additive value of ACPA assessment after testing for RF level was higher than vice versa. The association between high RF level and RA severity was not as strong as that between ACPA antibodies and RA severity. The RF level obtained by different methods in the same patients' sera varied considerably.
Conclusion. Our findings indicate that determination of RF level is subject to large variation; high RF level has limited additive prognostic value compared to ACPA positivity. Thus, omitting RF level and using RF presence, ACPA presence, and ACPA level may improve the 2010 criteria for RA.Pathophysiology and treatment of rheumatic disease