Influence of anti-cyclic citrullinated peptide on disease activity, structural severity, and bone loss in Moroccan women with rheumatoid arthritis

Abstract Aim of the work The aim of this study was to assess the influence of anti- cyclic citrullinated peptide(anti-CCP) on disease activity, radiological severity, functional disability and bone loss in Moroccan women with rheumatoid arthritis (RA). Patients and methods One hundred and thirty-six women with RA were recruited. Age, weight, height, disease duration and steroids cumulative dosewere identified. Anti-CCP and Rheumatoid factor(RF) were determined. Disease activity score (DAS28) was assessed and functional repercussion measured by the Health AssessmentQuestionnaire-disability index (HAQ-DI). Radiological status was assessed by the Sharp/van der Heijde (SvH) erosion and narrowing score. Bone mineral density was determined by a Lunar Prodigy Vision Dual-energy X-ray absorptiometry and vertebral fracture assessment was classified using a combination of Genant semi-quantitative approach and morphometry. Results Patients mean age was 49.6 ± 7.4 years and disease duration 7.7 ± 5 years. 109 (80.1%) patients were anti-CCP positive. There was no significant difference in DAS28 between patients with and without anti-CCP. Nevertheless, weight, erythrocyte sedimentation rate(ESR), rheumatoid factortiter and positivity, SvH narrowing and erosion score and osteoporosis were significantly higher in patients with positive anti-CCP. Stepwise regression analysis showed that the presence of anti-CCP was independently associated with osteoporosis and SvH erosion score. Conclusions Anti-CCP antibodies are strongly predictive for the development of osteoporosis and erosions in Moroccan RA patients. They not only have a valuable role in the disease prognosis prediction but also may be a relevant determinant of bone loss in RA. The presence of these antibodies warrants special attention.