Abstract
Background.To provide data on the use of anti-cyclic citrullinated peptide antibody (anti-CCP) and other routinely used clinical parameters and to assess the impact of anti-CCP status on therapeutic decisions, an observational study was conducted in patients with rheumatoid arthritis (RA).Methods.Sixty-seven adult patients with a recent diagnosis of RA were recruited from four rheumatology centres in Lithuania and were prospectively observed for 12 months. Data collection was based on the review of medical records and routine examination of patients. Patients completed the Health Assessment Questionnaire – Disability Index and Patient Global Assessment of disease activity using a visual analogue scale. Physicians were asked about the importance of the anti-CCP results and other factors important for therapeutic decisions.Results.Of the 67 patients enrolled, 54 (80.6%) completed the study. At the beginning of the study, physicians considered anti-CCP results to be important for decision-making in 87.0% of patients. The perceived importance of anti-CCP results did not change significantly throughout the study. After one year of treatment, factors that were considered more important than the anti-CCP results included the presence of erosions, significantly increased C-reactive protein, duration of morning stiffness, multi-articular expanding, and rheumatoid factor status. For nearly half of the patients (n = 26; 48.1%), physicians would not change the treatment strategy if the patient had the opposite anti-CCP results at baseline.Conclusions.The study revealed that decision-making in the management of RA was based on multifactorial data. The role of anti-CCP as a single test in treatment decisions needs further investigation.
Highlights
Rheumatoid arthritis (RA), which affects 0.3% to 1% of the population [1], is an autoimmune disease characterised by chronic synovial inflammation
We present the data collected in Lithuania. This was a multi-centre, international, observational study conducted in Hungary, Romania, Estonia, Lithuania, and Croatia from 2008 to 2011
Patients in Lithuanian rheumatology centres were mostly treated with csDMARDs; only a few patients received biologic disease-modifying antirheumatic drug (bDMARD) therapy
Summary
Rheumatoid arthritis (RA), which affects 0.3% to 1% of the population [1], is an autoimmune disease characterised by chronic synovial inflammation. Joint damage occurs at the early stages of the disease. 75% of patients with early stage disease have joint erosions; the first erosions usually develop during the first two years of RA [4]. To prevent irreversible joint damage, early diagnosis and treatment initiation within the first three months of disease onset is essential [5]. In patients with RA, early therapy with combinations of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) may delay the development of joint damage for several years [5,6,7]. To provide data on the use of anti-cyclic citrullinated peptide antibody (anti-CCP) and other routinely used clinical parameters and to assess the impact of anti-CCP status on therapeutic decisions, an observational study was conducted in patients with rheumatoid arthritis (RA)
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