Rheumatology Medical News about very recent onset arthritis;anti-cyclic citrullinated peptide antibodies

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Very recent onset arthritis: The value of initial rheumatologist evaluation and anti-cyclic citrullinated peptide antibodies in the diagnosis of rheumatoid arthritis
Clinical Rheumatology, 06/10/09

Rojas-Serrano J et al. - Study demonstrates that the combination of rheumatid arthritis (RA) as predicted diagnosis by a rheumatologist and anti-CCP antibodies is highly specific for RA diagnosis in patients with very early arthritis.

Methods

Aim was to identify baseline factors associated with RA diagnosis at the end of 1-yr f/u in pts with very recent onset arthritis
Incident cases with self-reported arthritis (≤12 wks) were assessed by a designated rheumatologist
Diagnosis of RA: ≥1 swollen joint at the end of f/u
Pts were regularly seen and diagnosed through f/u

Results

78/119 referrals (65.5%; mean age: 35.5 yrs; 69 females) were diagnosed at baseline as very recent onset arthritis
66.5% pts completing 1-yr f/u were classified as RA
16% had self-limited arthritis; 17.5% other diagnoses
The characteristics of pts with RA as final diagnosis were:
- Polyarthritis
- Morning stiffness ≥1 h
- High counts of swollen joints, and
- Low frequency of systemic symptoms
Rheumatologist prediction of RA and anti-CCP Abs was strongly associated with RA as a final diagnosis
Sensitivity and specificity for:
- Rheumatologist prediction were- 94% and 74%
- Anti-CCP Abs- 56% and 96%
- Combination of both variables- 53% and 100% respectively, and a positive predictive value of 98%