Risk stratification using anti-citrullinated peptide antibodies (ACPA) in polyarticular subtypes of juvenile idiopathic arthritis in adulthood
Authors' conclusion
Our results suggest that pJIA RF+ ACPA+ adult patients may have a more severe articular phenotype than pJIA RF+ ACPA- patients.
Study context
- Population
- Adult patients with polyarticular juvenile idiopathic arthritis (pJIA) and available data for ACPA, RF and X-ray
- Participants
- 56 adult pJIA patients
- Exposure
- ACPA+ vs ACPA− pJIA in adulthood
- pJIA RF+n = 35
- pJIA RF-n = 21reference
- Outcome
- Structural damage (Sharp Van Der Heijde scores)
Methodological detailsblinded independent scoring by two investigators
- Blinded independent scoring by two investigators
Main finding
As reported in the abstract
Structural damage (Sharp Van Der Heijde scores) by ACPA status
- pJIA ACPA+ vs pJIA ACPA-: P < 0.05
Observational data: associations, not effects.
Further findings
| Outcome | pJIA RF+ | pJIA RF- | P value |
|---|---|---|---|
| ACPA positivity by RF statuspJIA RF+ vs pJIA RF- | 96% | 26% | P < 0.001 |
- Sharp van Der Heijde erosion and total scores by RF status · pJIA RF+ vs pJIA RF- · erosion score, higher with RF+
- P < 0.01
- Sharp van Der Heijde erosion and total scores by RF status · pJIA RF+ vs pJIA RF- · total score, higher with RF+
- P < 0.05
- bDMARD requirement by ACPA status · pJIA ACPA+ vs pJIA ACPA- · more bDMARDs required in ACPA+
- P < 0.05
ACPA levels in patients with high Sharp van Der Heijde JSN and total scores
- Significantly higher ACPA levels (P<0.01)
Correlation of ACPA levels with Sharp van Der Heijde total score
- R (P<0.05)
- 0.54
Structural damage in RF+ subgroup: ACPA+ vs ACPA-
- Erosion, JSN and total scores higher in pJIA RF+ ACPA+ than pJIA RF+ ACPA-, not significant
Original publication
Risk stratification using anti-citrullinated peptide antibodies (ACPA) in polyarticular subtypes of juvenile idiopathic arthritis in adulthood. Joint Bone Spine. Published 26 November 2022. doi:10.
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