Their conclusion comes from a cross-sectional study evaluating the role of genetic and serologic markers in predicting disease activity and joint destruction in RA.
Sixty patients with RA were assessed for the major histocompatibility complex, class II, DR beta 1 gene (HLA-DRB1) genotype and in particular the presence of the shared epitope, DRB1*01 or DRB1*04. They were also assessed for blood markers and underwent radiography.
Writing in the International Archives of Medicine, Nihal Fathi (Assiut University Hospital) and team reveal that C-reactive protein (CRP), anti-CCP antibodies, antikeratin antibody (AKA), and RF were detected in 56.7%, 83.3%, 52.0%, and 71.7% of patients, respectively.
HLA-DRB1*01 was present in 45% of RA patients while 35% had one or two HLA-DRB1*04 alleles. Both DRB1*01 and DRB1*04 were significantly more common in RA patients than in healthy controls.
In addition, the RF-associated allele DRB1*0405 was found in 80% of DRB1*04-positive patients, and DRB1*04 homozygotes were significantly more prevalent among RA patients versus controls (13% vs. 3%).
Both anti-CCP and the DRB1*04 allele were independent predictors of disease activity, with odds ratios of 19.6 and 5.1, respectively. For joint damage, the independent predictors were HLA-DRB1*04, HLA-DRB1*01, RF, and above-median CRP levels, with odds ratios of 5.5, 4.5, 2.5, and 2.0, respectively. p>Anti-CCP had the highest predictive value for disease activity, say the authors, with a sensitivity of 97% and a negative predictive value of 90%.
“Our findings suggest that anti-CCP is superior to RF for the detection of RA and provided predictive information on joint destruction and disease activity,” Fathi and co-authors conclude.
“The presence of RA-associated antibodies and/or the shared epitope genes are indicative for a poorer radiological outcome and higher grade of activity.”
Not sure if I understand though- the higher the number the more severe your RA is?
My rheumy told me that anytime you have a positive anti-ccp there is the potential for severe ra. My number was barely positive, but boy do I have it. I wouldn't say I am severe, but moderate. But considering that we have been very aggressive with treatment from the start, and I am not better but worse, I am frightened by what may come. So in my case, I would have expected a lower number to be less aggressive. As it turns out, we may have just caught the ra at its onset and I got diagnosed early before the number got higher. I am just basing this on my personal experience.gracie- In the beginning I was too sick to even think about asking for copies of my blood results so I don't know what my anti ccp number was although I know it was positive. I have been told I have severe RA by my doctor but I have rebounded in such a magnificent way I don't believe that to be true. He just repeated it-the results were not in at my visit and so far he hasn't called but the reading was <20 (U). It is not highlighted as high so I think that it is within range? Or negative? I will be calling him to discuss results- if I get any answers worth sharing I will.