van der Linden MP, van der Woude D, Ioan-Facsinay A et al. Arthritis Rheum 2009;60:2232–41.
The presence of autoantibodies is a key feature in the clinical evaluation of rheumatoid arthritis (RA) patients. In addition to the long-established rheumatoid factor (RF), there are now three tests for anti-citrullinated protein autoantibodies (ACPAs): the second-generation anti-cyclic citrullinated peptide (anti-CCP-2), the third-generation anti-CCP (anti-CCP-3), and the anti-modified citrullinated vimentin autoantibody tests. In this detailed analysis of patients in a clinical practice setting, a single autoantibody test was found to be sufficient for risk estimation in early undifferentiated arthritis with respect to the risk of developing RA, for predicting joint damage in RA, and the risk of having persistent disease.
In the present study, the utility of rheumatoid factor (RF) and anti-citrullinated protein autoantibody (ACPA) tests (second-generation anti-cyclic citrullinated peptide [anti-CCP-2], third-generation anti-CCP [anti-CCP-3], and anti-modified citrullinated vimentin autoantibody), and combinations thereof, to predict outcomes in >600 patients with undifferentiated arthritis (UA) and >600 patients with rheumatoid arthritis (RA) were evaluated. The three outcome measures assessed in these patients were progression from UA to RA, the rate of joint destruction in RA, and the chance of achieving sustained disease-modifying antirheumatic drug (DMARD)-free remission in RA.