Anti–Carbamylated Fibrinogen Autoantibodies of IgG and IgA Isotypes Contribute to a Better Prognostic Stratification in Very Early Rheumatoid Arthritis: Data From the French National ESPOIR Cohort
Authors' conclusion
The distinct longitudinal behavior and prognostic associations of ACa-Fib IgG and IgA highlight a previously underappreciated component of the anti-carbamylated protein response and support their utility as complementary biomarkers for improved risk stratification in early RA.
Study context
- Population
- Patients with very early rheumatoid arthritis (RA) with available 2010 ACR/EULAR classification criteria, French ESPOIR cohort575 with RA
- Participants
- 619 patients
- Outcome
- Prevalence and longitudinal evolution of ACa-Fib IgG and IgA, and their diagnostic and prognostic value beyond anti-CCP and RF
Methodological detailsmulticentre national cohort (ESPOIR), longitudinal (baseline, 6 and 24 months), multivariable models
- Multicentre national cohort (ESPOIR)
- Longitudinal (baseline, 6 and 24 months)
- Multivariable models
Main finding
As reported in the abstract
ACa-Fib IgG detected in anti-cyclic citrullinated peptide (anti-CCP)-negative RA
16.6%
ACa-Fib IgA detected in anti-CCP-negative RA
6.3%
Observational data: associations, not effects.
Further findings
Structural progression, ACa-Fib IgA (≥3.07 AU)
| OR (95% CI) | P value | ||
|---|---|---|---|
| ACa-Fib IgA ≥3.07 AU | 1.9 (1.1–3.4) | P = 0.031 | |
| 0.20.5125Odds ratio (log scale) |
Therapeutic response or remission · baseline levels
- Baseline ACa-Fib levels not associated with therapeutic response or remission
Longitudinal evolution of ACa-Fib levels · 24 months
- ACa-Fib IgG levels decreased; IgA levels remained stable
ACa-Fib IgA and smoking
- Higher ACa-Fib IgA associated with longer smoking duration
- P = 0.003
- Higher ACa-Fib IgA associated with cumulative smoking exposure
- P = 0.016
Rapid radiographic progression, highest quartile of ACa-Fib IgG (≥20.29 AU)
- Increased risk of rapid radiographic progression
- global P = 0.004
Original publication
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