PMID- 28505163 OWN - NLM STAT- MEDLINE DCOM- 20170920 LR - 20181113 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 12 IP - 5 DP - 2017 TI - Anti-citrullinated peptide antibodies are the strongest predictor of clinically relevant radiographic progression in rheumatoid arthritis patients achieving remission or low disease activity: A post hoc analysis of a nationwide cohort in Japan. PG - e0175281 LID - 10.1371/journal.pone.0175281 [doi] LID - e0175281 AB - OBJECTIVES: To determine prognostic factors of clinically relevant radiographic progression (CRRP) in patients with rheumatoid arthritis (RA) achieving remission or low disease activity (LDA) in clinical practice. METHODS: Using data from a nationwide, multicenter, prospective study in Japan, we evaluated 198 biological disease-modifying antirheumatic drug (bDMARD)-naive RA patients who were in remission or had LDA at study entry after being treated with conventional synthetic DMARDs (csDMARDs). CRRP was defined as the yearly progression of modified total Sharp score (mTSS) >3.0 U. We performed a multiple logistic regression analysis to explore the factors to predict CRRP at 1 year. We used receiver operating characteristic (ROC) curve to estimate the performance of relevant variables for predicting CRRP. RESULTS: The mean Disease Activity Score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR) was 2.32 +/- 0.58 at study entry. During the 1-year observation, remission or LDA persisted in 72% of the patients. CRRP was observed in 7.6% of the patients. The multiple logistic regression analysis revealed that the independent variables to predict the development of CRRP were: anti-citrullinated peptide antibodies (ACPA) positivity at baseline (OR = 15.2, 95%CI 2.64-299), time-integrated DAS28-ESR during the 1 year post-baseline (7.85-unit increase, OR = 1.83, 95%CI 1.03-3.45), and the mTSS at baseline (13-unit increase, OR = 1.22, 95%CI 1.06-1.42). CONCLUSIONS: ACPA positivity was the strongest independent predictor of CRRP in patients with RA in remission or LDA. Physicians should recognize ACPA as a poor-prognosis factor regarding the radiographic outcome of RA, even among patients showing a clinically favorable response to DMARDs. FAU - Koga, Tomohiro AU - Koga T AUID- ORCID: 0000-0003-2077-4428 AD - Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan. AD - Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan. FAU - Okada, Akitomo AU - Okada A AD - Japanese Red Cross Nagasaki Genbaku Hospital, Department of Rheumatology, Mori-machi 3-15, Nagasaki, Japan. FAU - Fukuda, Takaaki AU - Fukuda T AD - Kurume University Medical Center, Department of Rheumatology, Kokubun 155-1, Kurume, Japan. FAU - Hidaka, Toshihiko AU - Hidaka T AD - Zenjinkai Shimin-no-Mori Hospital, Shioji 2783-37, Miyazaki, Japan. FAU - Ishii, Tomonori AU - Ishii T AD - Tohoku University Hospital, Department of Hematology and Rheumatology, Aoba-ku, seiryo 1-1, Sendai, Japan. FAU - Ueki, Yukitaka AU - Ueki Y AD - Sasebo Chuo Hospital, Rheumatic and Collagen Disease Center, Yamato 15, Sasebo, Japan. FAU - Kodera, Takao AU - Kodera T AD - Tohoku Medical and Pharmaceutical University Hospital, Aoba-ku, komatsujima 4-4-1, Sendai, Japan. FAU - Nakashima, Munetoshi AU - Nakashima M AD - Japanese Red Cross Nagasaki Genbaku Hospital, Department of Rheumatology, Mori-machi 3-15, Nagasaki, Japan. AD - Kurume University Medical Center, Department of Rheumatology, Kokubun 155-1, Kurume, Japan. FAU - Takahashi, Yuichi AU - Takahashi Y AD - Yu Family Clinic, Rifu-aza sinkan 2-5, Miyagi, Japan. FAU - Honda, Seiyo AU - Honda S AD - Kurume University School of Medicine, asahi-machi 67, Kurume, Japan. FAU - Horai, Yoshiro AU - Horai Y AD - Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan. FAU - Watanabe, Ryu AU - Watanabe R AD - Tohoku University Hospital, Department of Hematology and Rheumatology, Aoba-ku, seiryo 1-1, Sendai, Japan. FAU - Okuno, Hiroshi AU - Okuno H AD - Tohoku University Hospital, Department of Orthopaedic Surgery, Hirase 9-3, Sasebo, Japan. FAU - Aramaki, Toshiyuki AU - Aramaki T AD - Japanese Red Cross Nagasaki Genbaku Hospital, Department of Rheumatology, Mori-machi 3-15, Nagasaki, Japan. AD - Sasebo Chuo Hospital, Rheumatic and Collagen Disease Center, Yamato 15, Sasebo, Japan. FAU - Izumiyama, Tomomasa AU - Izumiyama T AD - East Sendai Rheumatism and internal medicine Clinic, Miyagino, Nittahigashi 1-17-5, Sendai, Japan. FAU - Takai, Osamu AU - Takai O AD - Osaki Citizen Hospital, Furukawa-honami 3-8-1, Osaki, Japan. FAU - Miyashita, Taiichiro AU - Miyashita T AD - NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki Japan. FAU - Sato, Shuntaro AU - Sato S AD - Clinical Research Center, Nagasaki University Hospital, Sakamoto 1-7-1, Nagasaki, Japan. FAU - Kawashiri, Shin-Ya AU - Kawashiri SY AD - Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan. AD - Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-12-4, Nagasaki, Japan. FAU - Iwamoto, Naoki AU - Iwamoto N AD - Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan. FAU - Ichinose, Kunihiro AU - Ichinose K AD - Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan. FAU - Tamai, Mami AU - Tamai M AD - Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan. FAU - Origuchi, Tomoki AU - Origuchi T AD - Department of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-12-4, Nagasaki, Japan. FAU - Nakamura, Hideki AU - Nakamura H AD - Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan. FAU - Aoyagi, Kiyoshi AU - Aoyagi K AD - Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-12-4, Nagasaki, Japan. FAU - Eguchi, Katsumi AU - Eguchi K AD - Sasebo City General Hospital, Hirase 9-3, Sasebo, Japan. FAU - Kawakami, Atsushi AU - Kawakami A AD - Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, Japan. CN - Japanese RA Patients with RRP Study Group LA - eng PT - Journal Article DEP - 20170515 PL - United States TA - PLoS One JT - PloS one JID - 101285081 RN - 0 (Autoantibodies) RN - 0 (Biomarkers) RN - 0 (Peptide Fragments) SB - IM MH - Aged MH - Arthritis, Rheumatoid/*diagnosis/drug therapy/*immunology MH - Autoantibodies/*immunology MH - Biomarkers MH - Cohort Studies MH - Disease Progression MH - Female MH - Humans MH - Japan MH - Male MH - Middle Aged MH - Odds Ratio MH - Peptide Fragments/antagonists & inhibitors/*immunology MH - Prognosis MH - ROC Curve MH - Radiography MH - Severity of Illness Index MH - Treatment Outcome PMC - PMC5432072 COIS- Competing Interests: The authors have declared that no competing interests exist. EDAT- 2017/05/16 06:00 MHDA- 2017/09/21 06:00 PMCR- 2017/05/15 CRDT- 2017/05/16 06:00 PHST- 2017/02/08 00:00 [received] PHST- 2017/03/23 00:00 [accepted] PHST- 2017/05/16 06:00 [entrez] PHST- 2017/05/16 06:00 [pubmed] PHST- 2017/09/21 06:00 [medline] PHST- 2017/05/15 00:00 [pmc-release] AID - PONE-D-17-05115 [pii] AID - 10.1371/journal.pone.0175281 [doi] PST - epublish SO - PLoS One. 2017 May 15;12(5):e0175281. doi: 10.1371/journal.pone.0175281. eCollection 2017.