Value of Measuring Anti-Carbamylated Protein Antibodies for Classification on Early Arthritis Patients.
Cristina RegueiroLaura NuñoAna M OrtizDiana PeiteadoAlejandro VillalbaDora Pascual-SalcedoAna Martínez-FeitoIsidoro González-AlvaroAlejandro BalsaAntonio GonzálezPublished in: Scientific reports (2017)
Classification of patients with rheumatoid arthritis (RA) as quickly as possible improves their prognosis. This reason motivates specially dedicated early arthritis (EA) clinics. Here, we have used 1062 EA patients with two years of follow-up to explore the value of anti-carbamylated protein (anti-CarP) antibodies, a new type of RA specific autoantibodies, for classification. Specifically, we aimed to determine whether the addition of anti-CarP antibodies to IgM rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies, which are helpful in RA classification, improves it or not. Our analysis showed that incorporation of the anti-CarP antibodies to combinations of the other two antibodies (all joint by the OR Boolean operator) produces a modest increase in sensitivity (2.2% higher), at the cost of decreased specificity (8.1% lower). The cost-benefit ratio was more favorable in the patients lacking the other autoantibodies. However, it did not improve by considering different titer levels of the anti-CarP antibodies, or after exhaustively exploring other antibody combinations. Therefore, the place in RA classification of these antibodies is questionable in the context of current treatments and biomarkers. This conclusion does not exclude their potential value for stratifying patients in joint damage, disease activity, disability, or mortality categories.
Keyphrases
- rheumatoid arthritis
- disease activity
- end stage renal disease
- machine learning
- systemic lupus erythematosus
- ejection fraction
- deep learning
- chronic kidney disease
- prognostic factors
- ankylosing spondylitis
- rheumatoid arthritis patients
- oxidative stress
- patient reported outcomes
- cardiovascular disease
- small molecule
- risk assessment
- systemic sclerosis
- interstitial lung disease
- climate change
- amino acid
- protein protein
- idiopathic pulmonary fibrosis