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RF, ACPA presence, not levels, linked with mortality risk
Rheumatoid factor and anti-citrullinated protein antibody levels were found to be predictors of mortality in patients with early inflammatory arthritis, according to results of a recently published study.
Data were collected from the Norfolk Arthritis Register (NOAR) in the U.K. and Leiden Early Arthritis Clinic (EAC) in the Netherlands.
Patients in Norfolk, U.K. with symptom duration for 2 years or less were enrolled in NOAR between 1990 and 2009 and in EAC from 1993. A total of 4,962 patients were identified with early inflammatory arthritis. All patients were older than 16 years of age and had two or more swollen joints for 4 or more weeks. Both cohorts had similar age and gender distributions, and 57% of patients in Leiden EAC met 2010 American College of Rheumatology / European League Against Rheumatism classification criteria compared with 63% of NOAR patients.
The researchers recorded patients’ demographics and smoking status at baseline, and rheumatoid factor (RF), anti-citrullinated protein antibody (ACPA) levels and inflammatory markers were measured. Patients’ antibody statuses were stratified as negative, low or high-positive based on RF and ACPA levels. The researchers then used Cox regression models to determine associations between antibody status and mortality.
Study results showed there were no consistent findings between the two patient groups when antibody status was stratified as either negative, low or high-positive.
During the study period, the NOAR cohort had 787 deaths per 36,109 person-years and the EAC cohort had 275 deaths over 16,187 person-years, resulting in crude death rates of 21.8 and 17 deaths per 1,000 person-years, respectively, according to the researchers.
The researchers found that when antibody status was stratified, there were no consistent findings between the two cohorts; however, they also found that double antibody positivity was associated with higher levels of mortality in each cohort compared with seronegative patients.
Disclosure: The authors have no relevant financial disclosures.