TY - JOUR T1 - Anticollagen type II antibodies are associated with an acute onset rheumatoid arthritis phenotype and prognosticate lower degree of inflammation during 5 years follow-up. AU - Manivel,Vivek Anand, AU - Mullazehi,Mohammed, AU - Padyukov,Leonid, AU - Westerlind,Helga, AU - Klareskog,Lars, AU - Alfredsson,Lars, AU - Saevarsdottir,Saedis, AU - Rönnelid,Johan, Y1 - 2017/03/23/ PY - 2016/11/25/received PY - 2017/02/26/revised PY - 2017/03/02/accepted PY - 2017/3/25/pubmed PY - 2017/8/22/medline PY - 2017/3/25/entrez KW - DAS28 KW - Outcomes research KW - Rheumatoid Arthritis SP - 1529 EP - 1536 JF - Annals of the rheumatic diseases JO - Ann Rheum Dis VL - 76 IS - 9 N2 - OBJECTIVE: Antifibrillar collagen type II (anti-CII) antibody-positive patients with rheumatoid arthritis (RA) have early but not late signs of increased inflammation and joint erosions. We wanted to replicate this in a large RA cohort, and to relate to human leukocyte antigen (HLA)-DRB1* alleles. METHODS: Anti-CII and anti-cyclic citrullinated peptide (CCP)2 were measured at baseline in 773 patients with RA from the Swedish Epidemiological Investigation in Rheumatoid Arthritis (EIRA) study with clinical follow-up data from the Swedish Rheumatology Quality Register (SRQ) registry, and 1476 with HLA-DRB1* information. Comparisons were done concerning C reactive protein (CRP), erythrocyte sedimentation rate (ESR), tender joint count (TJC), swollen joint count (SJC), Disease Activity Score encompassing 28 joints based on ESR (DAS28), DAS28CRP, pain-Visual Analogue Scale (VAS), global-VAS and Health Assessment Questionnaire Score (HAQ) at eight occasions during 5 years, and association with HLA-DRB1* alleles. RESULTS: Anti-CII associated with elevated CRP, ESR, SJC, DAS28 and DAS28CRP at diagnosis and up to 6 months, whereas anti-CCP2 associated with SJC and DAS28 from 6 months to 5 years, but not earlier. The anti-CII-associated phenotype was strong, and predominated in anti-CII/anti-CCP2 double-positive patients. Anti-CII was associated with improvements in CRP, ESR, SJC, TJC and DAS28, whereas anti-CCP2 was associated with deteriorations in SJC and DAS28 over time. Anti-CII-positive patients achieved European League Against Rheumatism good or moderate response more often than negative patients. Anti-CII was positively associated with HLA-DRB1*01 and HLA-DRB1*03, with significant interaction, and double-positive individuals had >14 times higher mean anti-CII levels than HLA double negatives. Whereas smoking was associated with elevated anti-CCP2 levels, smokers had lower anti-CII levels. CONCLUSIONS: Anti-CII seropositive RA represents a distinct phenotype, in many respects representing the converse to the clinical, genetic and smoking associations described for anticitrullinated protein peptide autoantibodies. Although not diagnostically useful, early anti-CII determinations predict favourable inflammatory outcome in RA. SN - 1468-2060 UR - https://www.unboundmedicine.com/medline/citation/28336519/Anticollagen_type_II_antibodies_are_associated_with_an_acute_onset_rheumatoid_arthritis_phenotype_and_prognosticate_lower_degree_of_inflammation_during_5_years_follow_up_ L2 - https://ard.bmj.com/lookup/pmidlookup?view=long&pmid=28336519 DB - PRIME DP - Unbound Medicine ER -