Anti-citrullinated protein antibodies are associated with osteopenia but not with pain at diagnosis of rheumatoid arthritis: data from the BARFOT cohort

Arthritis Research & Therapy

Björn Svensson¹  Kristina Forslind²  Ingiäld Hafström³  Sofia Ajeganova⁴ 

[1] Department of Clinical Science, Section of Rheumatology, Faculty of Medicine Lund University;Department of Clinical Science, Section of Rheumatology, Faculty of Medicine, Lund University;Division of Gastroenterology and Rheumatology, Department of Medicine, Huddinge, Karolinska Institutet, and Rheumatology unit R92, Karolinska University Hospital;Division of Gastroenterology and Rheumatology, Department of Medicine, Karolinska Institutet;

关键词: Rheumatoid arthritis;    Anti-citrullinated protein antibodies;    Bone mineral density;    Pain;   

DOI  :  10.1186/s13075-019-1833-y

来源: DOAJ

【 摘 要 】

Abstract Background Anti-citrullinated protein antibodies (ACPA) have been suggested to have a potential role in both bone loss and pain in rheumatoid arthritis (RA), based on studies in vitro and in animal models. Here we addressed if anti-cyclic citrullinated (anti-CCP) antibodies were associated with osteopenia or pain in patients with RA, at the time for diagnosis. Methods Baseline data from the BARFOT (Better Anti-Rheumatic PharmacOTherapy) cohort, which consists of patients with RA with a disease duration of 1 year or less, were analyzed. To be included, they should have been assessed by anti-CCP, dual-energy X-ray absorptiometry (DEXA) of lumbar spine and hip, and/or digital X-ray radiogrammetry (DXR) of the metacarpal bones. Osteopenia was defined as a z-score < − 1 SD. Pain VAS > 40 mm, was defined as patient unacceptable pain. Multiple logistic regression analyses were performed to assess whether anti-CCP was independently associated with osteopenia or unacceptable pain. Results Of the 657 patients, 65% were women, 58% were anti-CCP positive, 37% had osteopenia in the lumbar spine, and 29% had osteopenia in the hip. Sixty-one percent had unacceptable pain at diagnosis. Patients positive for anti-CCP had significantly more frequently osteopenia in the femoral neck and Ward’s triangle compared with anti-CCP-negative patients (p = 0.016 and 0.003, respectively). This difference was found in men at any anti-CCP titer, but in women, osteopenia in these hip locations was found only in those with high anti-CCP titers (> 500 IU/ml). Anti-CCP was not associated with osteopenia in the lumbar spine or the metacarpal bones. In multiple logistic regression analyses, anti-CCP was independently associated with osteopenia in the femoral neck and/or Ward’s triangle but not with unacceptable pain. Instead, inflammatory variables were independently associated with unacceptable pain. Conclusion These data show that in patients with early RA, anti-CCP positivity was independently associated with osteopenia in the femoral neck and/or Ward, but not in the lumbar spine. In our patients, we could not confirm a recently suggested association between anti-CCP antibodies and pain. Further studies are necessary to explore the possible clinical relevance of interactions between ACPA, bone, and pain found in vitro and in animal models.

【 授权许可】

Unknown