PT  - JOURNAL ARTICLE
AU  - Lillian Barra
AU  - Vivian Bykerk
AU  - Janet E.  Pope
AU  - Boulos P.  Haraoui
AU  - Carol A.  Hitchon
AU  - J. Carter  Thorne
AU  - Edward C.  Keystone
AU  - Gilles Boire
AU  - , and the CATCH Investigators
TI  - Anticitrullinated Protein Antibodies and Rheumatoid Factor Fluctuate in Early Inflammatory Arthritis and Do Not Predict Clinical Outcomes
AID  - 10.3899/jrheum.120736
DP  - 2013 Feb 01
TA  - The Journal of Rheumatology
PG  - jrheum.120736
4099  - http://www.jrheum.org/content/early/2013/01/27/jrheum.120736.short
4100  - http://www.jrheum.org/content/early/2013/01/27/jrheum.120736.full
AB  - Objective In inflammatory arthritis, rheumatoid factor (RF) and anticitrullinated protein antibodies (ACPA) are believed to be associated with more severe clinical outcomes. Our objective was to determine whether ACPA and RF remain stable in early inflammatory arthritis and whether their trajectories over time or baseline levels predicted clinical outcomes. Methods The study population consisted of patients enrolled in the Canadian Early Arthritis Cohort Study with baseline and at least 12-month followup values of RF and ACPA. Primary outcomes were Disease Activity Score (DAS) remission and the presence of erosions at 12 and 24 months. Other objectives included swollen joint count, Health Assessment Questionnaire score, and DAS. Results At baseline, 225/342 (66%) patients were ACPA-positive and 334/520 (64%) were RF-positive. At 24 months, 15/181 (8%) ACPA-positive patients became negative. A larger number of patients changed from ACPA-negative to positive: 13/123 (11%). For RF, fluctuations were more common: 67/240 (28%) reverted from positive to negative and 21/136 (18%) converted from negative to positive. RF and ACPA fluctuations did not predict disease outcomes. Patients who remained ACPA-positive throughout followup were more likely to have erosive disease (OR 3.86, 95% CI 1.68, 8.92). Conclusion RF and ACPA have the potential to revert and convert during the early course of disease. Fluctuations in RF and ACPA were not associated with clinical outcomes.