February 02/13: anti-CCP testing can predict progression to rheumatoid arthritis in Sjögren’s syndrome
Ryu YS, Park SH, Lee J, Kwok SK, Ju JH, Kim HY, Jeon CH
Follow-up of primary Sjögren's syndrome patients presenting positive anti-cyclic citrullinated peptides antibody
Rheumatol.Int. 2012; doi 10.I007/s00296-0I2-2572-4
In primary Sjögren's syndrome (pSS) articular manifestations belong to the most common extra-glandular manifestations. However the specific clinical characteristics and treatments of such articular manifestations, specifically, the long-term outcome and progression to rheumatoid arthritis (RA) remain unknown.
This study assessed the clinical features of pSS patients positive for anti-cyclic citrullinated peptide antibodies (anti-CCP) and the clinical significance of the anti-CCP antibody in pSS over a 60 month follow-up period.
38 of 405 pSS patients had anti-CCP (36 of them had also RF). After 60 months 23 of 405 pSS patients (5.6 %) developed RA. All 23 were positive for anti-CCP. The anti-CCP antibody titers, but not the RF titers, showed an independent association with the progression.
Patients positive for anti-CCP showed a significant higher rate of arthralgia, arthritis and progression to RA.
Because pSS patients positive for anti-CCP antibody are up to three times more likely to progress to RA, patients having arthritis and a positive anti-CCP antibody serology should be closely observed and medical treatment should be considered.
This study shows that anti-CCP is closely associated with the prevalence of arthralgia, arthritis and the progression to RA in primary Sjögren's syndrome. Therefore the measurement of anti-CCP seems to be a helpful tool to early detect progression to RA during the pSS disease course.