A Study of Correlation of Disease Severity with Antibody Titers in Rheumatoid Arthritis
Published: February 1, 2019 | DOI: https://doi.org/10.7860/JCDR/2019/34558.12558
Praveen Singh Madan, Amarnath Dinakar Savur, Surendra Umesh Kamath, Shrikala Baliga, Sharan Mallya
1. Senior Resident, Gosford Hospital, NSW, Australia.
2. Professor, Department of Orthopaedics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India.
3. Professor, Department of Orthopaedics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India.
4. Professor, Department of Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India.
5. Assistant Professor, Department of Orthopaedics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India.
Correspondence
Dr. Amarnath Dinakar Savur,
Department of Orthopaedics, Kasturba Medical College, Light House Hill Road, Mangalore-575001, Karnataka, India.
E-mail: amarsavur@yahoo.com
Introduction: Rheumatoid Arthritis (RA) is one of the most frequent autoimmune diseases in the world which affects about 1% of people. Anti-Cyclic Citrullinated Peptides (Anti-CCP) is shown to be more specific than rheumatoid factor in the diagnosis of RA. This test becomes positive in early stage of disease and it has a high predictive value.
Aim: To correlate the relationship between anti-CCP antibody and rheumatoid factor titers and disease activity scores.
Materials and Methods: A cross-sectional study was performed in 50 patients with RA for evaluating the relation between anti-CCP antibody titer and Disease Activity Score 28 (DAS28), Simplified Disease Activity Index (SDAI) and Clinical Disease Activity Index (CDAI). A detailed examination of each patient including their demographic characteristics, duration of disease, number of tender and swollen joints, ESR and C-reactive protein, patient’s and physician’s global assessment by VAS (0-10) and titers of rheumatoid factor and anti-CCP antibody. Patients who fulfilled the ACR-EULAR 2010 criteria were included. The statistical analysis was done using Pearson’s correlation coefficient. A p-value of less than 0.05 was considered significant.
Results: Of the 50 patients which were included (mean age, 44.82 range, 18-70), 38 were females and 12 were males. Mean ESR was 54±27 mm/hr and Mean CRP was 17.277±23.41 mg/dL. Mean DAS 28 was 5.955±0.962; mean SDAI was 46.9±27.1 and CDAI 28.9±10.8. There was positive correlation (p<0.001) between DAS28 and SDAI (r=0.550) and CDAI (r=0.808). Anti-CCP level was associated with SDAI (r=0.317) and CDAI (r=0.282) (p<0.05).
Conclusion: There was significant correlation in the titers of anti-CCP and disease activity indices-SDAI and CDAI. Patients with higher levels of anti-CCP antibody had greater activity.
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