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Survivin associated with smoking, aCCP in early RA patients
Survivin, an inhibitor of apoptosis protein that predicts joint damage and persistent disease activity, was associated with smoking and antibodies against cyclic citrullinated peptides in patients with early rheumatoid arthritis, according to recent study results.
Researchers in Sweden studied 339 patients with early rheumatoid arthritis (RA; mean age, 56.5 years; 66% women) between September 1993 and December 1999. Patients were previously disease-modifying antirheumatic drug- or prednisolone-naive. Survivin levels were measured from serum collected at baseline and after 24 months.
“The association of survivin status with joint damage [total Sharp-van der Heijde score], disease activity [DAS28], functional disability [health assessment questionnaire (HAQ)], and pain perception [visual analog scale (VAS)] was calculated in the groups positive and negative for survivin … and for the positive-negative and negative-positive groups,” the researchers reported.
Seventy-nine percent of patients (n=268) experienced similar levels of survivin at baseline and after 24 months, while 15.6% converted from being survivin-positive to negative and 5.3% from negative to positive.
Patients who ever smoked had significantly greater survivin positivity at baseline compared with nonsmokers (OR=1.79; 95% CI, 1.16-2.76). High levels of survivin were more frequent at baseline and 24 months when patients smoked and had antibodies against cyclic citrullinated peptides (aCCP; OR=4.36; 95% CI, 2.64-7.2; positive predictive value=0.66; specificity=0.83).
Joint damage progression, significantly higher DAS28 and lower rate of remission at 24 and 60 months were associated with survivin positivity when compared with patients who tested negative at both intervals. Changes in HAQ and VAS had less association with survivin status.
“Survivin is a relevant and reproducible marker of severe RA,” the researchers concluded. “Survivin productivity on both test occasions was associated with … persistent disease activity and joint damage. Survivin may be included in predictive models for improved treatment decisions in patients with early RA.”
Disclosure: The researchers report no relevant financial disclosures.