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ACPA-positive patients with antisynthetase syndrome may also have RA
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Patients with antisynthetase syndrome who test positively for anti-citrullinated peptide antibodies may have overlapping rheumatoid arthritis or another rheumatic disease, according to recently published study data.
A case-control, retrospective study of 17 patients with antisynthetase syndrome who had positive tests for anti-citrullinated peptide antibodies (ACPA) were compared with 34 patients with antisynthetase syndrome matched for age, sex and follow-up. For inclusion in the study, at least two positive tests for anti-aminoacyl tRNA synthetase and pulmonary, muscle, dermatological or rheumatic clinical involvement were required.
Four men and 13 women were ACPA-positive; mean age of onset was 45.6 years, and the proportion of smokers was similar in both groups. Patients were recruited from nine centers in France.
In ACPA-positive patients, the first symptoms to appear were polyarthralgia and/or polyarthritis in 88% of patients, whereas myositis was seen in 41% and interstitial lung disease (ILD) was present in 35% of ACPA-positive patients. Within 3 months of symptom onset, the ACPAs were detected, whereas antisynthetase autoantibodies were detected 2 months after onset of disease.
Six of the ACPA-positive patients with antisynthetase syndrome were diagnosed with rheumatoid arthritis (RA), five were diagnosed with dermatomyositis (DM) and one was diagnosed with polymyositis. In the non-ACPA group of patients, only 41% had some form of rheumatic disease, and less frequently with joint involvement, resulting in an odds ratio of 49.5 for rheumatic disease in the ACPA-positive patients, according to the researchers. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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