Autoanticorpos na artrite reumatoide inicial: coorte Brasília - resultados de uma análise seriada de três anos

Abstract

The diagnostic and prognostic value of the serial measurement of antibodies, such as rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), and anti-citrullinated vimentin (anti-Sa) antibodies, has not been defi ned in early rheumatoid arthritis (ERA). Objectives: To prospectively assess the presence of RF, anti-CCP, and anti-Sa in ERA patients. Patients and methods: Forty ERA (less than 12 months) patients of the Brasília cohort were evaluated and followed up for three years. Both clinical and demographic data were recorded, in addition to the results (ELISA) of RF (IgM, IgG, and IgA), anti-CCP (CCP2, CCP3, and CCP3.1), and anti-Sa at the baseline assessment and after 3, 6, 12, 18, 24 and 36 months of follow-up. The results were compared by use of Student t test and paired t test. Results: The patients’ mean age was 45 years, and 90% of them were female. At the time of diagnosis, RF was identifi ed in 50% of the patients (RF IgA, 42%; RF IgG, 30%; and RF IgM, 50%), anti-CCP in 52.5% (no difference between CCP2, CCP3, and CCP3.1), and anti-Sa in 10%. After three years, no difference was observed in RF and anti-CCP prevalence, but anti-Sa increased to 17.5% (P = 0.001). Conclusion: Repeated RF and anti-CCP measurement, including different isotypes, during three years of follow-up showed no signifi cant changes. The third generation of anti-CCP assays did not increase the diagnostic value of the second-generation assays.