Rheumatoid Arthritis: Seropositivity versus Seronegativity; A Comparative Cross-sectional Study Arising from Moroccan Context

Author(s): Ksir Salma*, Akasbi Nessrine, Efemba Krystel, El Kinany Khaoula, Naji Noura, Elkohen Khadija, Harzy Taoufik

Journal Name: Current Rheumatology Reviews

Volume 16 , Issue 2 , 2020

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Abstract:

Introduction: Rheumatoid arthritis (RA) is biologically marked by a positive serum rate of rheumatoid factor (RA) and/or anti-citrullinated protein antibodies (ACPA). Nevertheless, 20% of RA cases remain seronegative.

Objective: The main purpose of this study, is to bring out the clinical, biological, imaging, therapeutic, and evolutionary distinctions between seropositive RA and seronegative one.

Methods: This is an observational cross-sectional study that involves patients with RA admitted in the rheumatology department, from the period between January 2012 and January 2018. RA seronegativity is described as the absence of both RF and ACPA, while seropositivity is recognized by the presence of at least one of the two antibodies.

Results: 294 patients were included, of which 90% were seropositive and 10% seronegative. Therefore, RA in this study is seropositive most often. The bivariate analysis underscored plenty of differences, statistically notable, according to the RA immune status. In fact, patients with seropositive RA had more synovitis (p=0.049), more deformities (p=0.01), and more bone destruction on radiographs (p=0.04). Furthermore, RA in this Moroccan study was quite severe (p=0.006) and got more complicated by systemic manifestations (p=0.02). Whereas, no distinction was brought up between the two groups, concerning the use of biotherapy. As for the multivariate study, seropositive RA in these patients, had greater severity (p=0.009, OR=4.53) and was more deforming (p=0.03 OR=2.45).

Conclusion: RA in our Moroccan context is dominated by the seropositive form. This seropositivity is often coupled with clinical severity and joint destruction, resulting in more deformities.

Keywords: Rheumatoid arthritis, seropositive, seronegative, rheumatoid factor, ACPA, deformities.

[1]
Avouac J, Gossec L, Dougados M. Diagnostic and predictive value of anti-cyclic citrullinated protein antibodies in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis 2006; 65(7): 845-51.
[http://dx.doi.org/10.1136/ard.2006.051391] [PMID: 16606649]
[2]
Fabien N, Goetz J, Sordet C, Humbel RL, Sibilia J. Groupe d’Etude de l’Auto-Immunité.Nouveaux autoanticorps de la polyarthrite rhumatoïde: les autoanticorps anti-peptides ou protéines citrullinées et les autres. Presse Med 2008; 37(12): 1756-66.
[http://dx.doi.org/10.1016/j.lpm.2008.06.020] [PMID: 18951757]
[3]
van der Linden MPM, van der Woude D, Ioan-Facsinay A, et al. Value of anti-modified citrullinated vimentin and third-generation anti-cyclic citrullinated peptide compared with second-generation anti-cyclic citrullinated peptide and rheumatoid factor in predicting disease outcome in undifferentiated arthritis and rheumatoid arthritis. Arthritis Rheum 2009; 60(8): 2232-41.
[http://dx.doi.org/10.1002/art.24716] [PMID: 19644872]
[4]
Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31(3): 315-24.
[http://dx.doi.org/10.1002/art.1780310302] [PMID: 3358796]
[5]
Villeneuve E, Nam J, Emery P. Rev Bras Reumatol. ACR-EULAR classification criteria for rheumatoid arthritis 2010; 50(5): 481-3.
[6]
Bouaddi I, El Badri D, Hassani A, et al. Les critères d’évaluation de la polyarthrite rhumatoïde. REV MAR RHUM 2012; 19: 19-23.
[7]
El Maghraoui A, Niamane R, Lahcen A, Allali F, Bahiri R, Bennouna MS, et al. Polyarthrite rhumatoïde Recommandations de bonnes Pratiques médicales . http://www.anam.ma/upload/ document/PolyarthriteRhumatoidepdf.pdf
[8]
Geng Y, Zhou W, Zhang ZL. A comparative study on the diversity of clinical features between the sero-negative and sero-positive rheumatoid arthritis patients. Rheumatol Int 2012; 32(12): 3897-901.
[http://dx.doi.org/10.1007/s00296-011-2329-5] [PMID: 22198665]
[9]
Abbas A, Slimani S. Caractéristiques des polyarthrites rhumatoïdes séronégatives: données à partir d’une cohorte algérienne. 24ème congrès de la société française de rhumatologie http://poster.rhumatologie.asso.fr/ModuleConsultationPoster/consultationPoster.aspx?intIdPoster=1922
[10]
Choi S, Lee K-H. Clinical management of seronegative and seropositive rheumatoid arthritis: A comparative study. PLoS One 2018; 13(4)e0195550
[http://dx.doi.org/10.1371/journal.pone.0195550] [PMID: 29624625]
[11]
Goldring SR, Gravallese EM. Pathogenesis of bone erosions in rheumatoid arthritis. Curr Opin Rheumatol 2000; 12(3): 195-9.
[http://dx.doi.org/10.1097/00002281-200005000-00006] [PMID: 10803748]
[12]
Ghozlani I, Achemlal L, Rezqi A, Mounach A, Bezza A, El Maghraoui A. Physiopathologie de la polyarthrite rhumatoïde. Rev Mar Rhum 2012; 19: 6-9.
[13]
Meyer O, Labarre C, Dougados M, et al. Anticitrullinated protein/peptide antibody assays in early rheumatoid arthritis for predicting five year radiographic damage. Ann Rheum Dis 2003; 62(2): 120-6.
[http://dx.doi.org/10.1136/ard.62.2.120] [PMID: 12525380]
[14]
Vencovský J, Machácek S, Sedová L, et al. Autoantibodies can be prognostic markers of an erosive disease in early rheumatoid arthritis. Ann Rheum Dis 2003; 62(5): 427-30.
[http://dx.doi.org/10.1136/ard.62.5.427] [PMID: 12695154]
[15]
van Jaarsveld CH, ter Borg EJ, Jacobs JW, et al. The prognostic value of the antiperinuclear factor, anti-citrullinated peptide antibodies and rheumatoid factor in early rheumatoid arthritis. Clin Exp Rheumatol 1999; 17(6): 689-97.
[PMID: 10609067]
[16]
Papadopoulos NG, Tsiaousis GZ, Pavlitou-Tsiontsi A, Giannakou A, Galanopoulou VK. Does the presence of anti-CCP autoantibodies and their serum levels influence the severity and activity in rheumatoid arthritis patients? Clin Rev Allergy Immunol 2008; 34(1): 11-5.
[http://dx.doi.org/10.1007/s12016-007-8018-1] [PMID: 18270851]
[17]
De Rycke L, Peene I, Hoffman IE, et al. Rheumatoid factor and anticitrullinated protein antibodies in rheumatoid arthritis: diagnostic value, associations with radiological progression rate, and extra-articular manifestations. Ann Rheum Dis 2004; 63(12): 1587-93.
[http://dx.doi.org/10.1136/ard.2003.017574] [PMID: 15547083]
[18]
Niamane R, Bahiri R, El Bouchti I, et al. Recommandations de la Société Marocaine de Rhumatologie pour la prise en charge de la polyarthrite rhumatoïde: mise à jour du référentiel de 2011. Rev Mar Rhum 2014; 30: 3-13.
[19]
Daien C, Hua C, Gaujoux-viala C, Cantagrel A, Dubremetz M, Dougados M, et al. Actualisation des recommandations de la société française de rhumatologie pour la prise en charge de la polyarthrite rhumatoide. Rev Rhum 2019; 86: 8-24.
[http://dx.doi.org/10.1016/j.rhum.2018.09.008]


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Article Details

VOLUME: 16
ISSUE: 2
Year: 2020
Page: [143 - 148]
Pages: 6
DOI: 10.2174/1573397115666191018115337
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