Influence of anti-cyclic citrullinated peptide on disease activity, structural severity, and bone loss in Moroccan women with rheumatoid arthritis

• Main Authors: Imad Ghozlani, Aziza Mounach, Mirieme Ghazi, Anass Kherrab, Radouane Niamane, Abdellah El Maghraoui
• Format: Article
• Language: English
• Published: Elsevier 2018-04-01
• Series: Egyptian Rheumatologist
• Online Access: http://www.sciencedirect.com/science/article/pii/S1110116417300832

Aim of the work: The aim of this study was to assess the influence of anti-cyclic citrullinated peptide (anti-CCP) on disease activity, radiological severity, functional disability and bone loss in Moroccan women with rheumatoid arthritis (RA). Patients and methods: One hundred and thirty-six women with RA were recruited. Age, weight, height, disease duration and steroids cumulative dose were identified. Anti-CCP and Rheumatoid factor (RF) were determined. Disease activity score (DAS28) was assessed and functional repercussion measured by the Health Assessment Questionnaire-disability index (HAQ-DI). Radiological status was assessed by the Sharp/van der Heijde (SvH) erosion and narrowing score. Bone mineral density was determined by a Lunar Prodigy Vision Dual-energy X-ray absorptiometry and vertebral fracture assessment was classified using a combination of Genant semi-quantitative approach and morphometry. Results: Patients mean age was 49.6 ± 7.4 years and disease duration 7.7 ± 5 years. 109 (80.1%) patients were anti-CCP positive. There was no significant difference in DAS28 between patients with and without anti-CCP. Nevertheless, weight, erythrocyte sedimentation rate (ESR), rheumatoid factor titer and positivity, SvH narrowing and erosion score and osteoporosis were significantly higher in patients with positive anti-CCP. Stepwise regression analysis showed that the presence of anti-CCP was independently associated with osteoporosis and SvH erosion score. Conclusions: Anti-CCP antibodies are strongly predictive for the development of osteoporosis and erosions in Moroccan RA patients. They not only have a valuable role in the disease prognosis prediction but also may be a relevant determinant of bone loss in RA. The presence of these antibodies warrants special attention. Keywords: Rheumatoid arthritis, Anti-cyclic citrullinated peptide, Disease activity, Joint damage, Bone loss