Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\25997035
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2015 ; 94
(20
): e523
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
In antisynthetase syndrome, ACPA are associated with severe and erosive
arthritis: an overlapping rheumatoid arthritis and antisynthetase syndrome
#MMPMID25997035
Meyer A
; Lefevre G
; Bierry G
; Duval A
; Ottaviani S
; Meyer O
; Tournadre A
; Le Goff B
; Messer L
; Buchdahl AL
; De Bandt M
; Deligny C
; Dubois M
; Coquerelle P
; Falgarone G
; Flipo RM
; Mathian A
; Geny B
; Amoura Z
; Benveniste O
; Hachulla E
; Sibilia J
; Hervier B
Medicine (Baltimore)
2015[May]; 94
(20
): e523
PMID25997035
show ga
Anticitrullinated peptide/protein antibodies (ACPA), which are highly specific
for rheumatoid arthritis (RA), may be found in some patients with other systemic
autoimmune diseases. The clinical significance of ACPA in patients with
antisynthetase syndrome (ASS), a systemic disease characterized by the
association of myositis, interstitial lung disease, polyarthralgia, and/or
polyarthritis, has not yet been evaluated with regard to phenotype, prognosis,
and response to treatment. ACPA-positive ASS patients were first identified among
a French multicenter registry of patients with ASS. Additionally, all French
rheumatology and internal medicine practitioners registered on the Club
Rhumatismes et Inflammation web site were asked to report their observations of
ASS patients with ACPA. The 17 collected patients were retrospectively studied
using a standardized questionnaire and compared with 34 unselected ACPA-negative
ASS patients in a case-control study. All ACPA-positive ASS patients suffered
from arthritis versus 41% in the control group (P?0.0001). The number of
swollen joints was significantly higher (7.0?±?5.0 vs 2.9?±?3.9, P?0.005), with
a distribution resembling that of RA. Radiographic damages were also more
frequent in ACPA-positive ASS patients (87% vs 11%, P?0.0001). Aside from a
significantly higher transfer factor for carbon monoxide in ACPA-ASS patients,
lung, muscle, and skin involvements had similar incidences, patterns, and
severity in both groups. Although Nonbiologic treatments were similarly used in
both groups, ACPA-positive patients received biologics more frequently (59% vs
12%, P?0.0008), mostly due to refractory arthritis (n?=?9). Eight patients
received anti-Cluster of differentiation 20 (CD20) monoclonal antibodies (mAbs)
with good efficacy and tolerance, whereas 2 of the 5 patients treated with
antitumor necrosis factor drugs had worsened myositis and/or interstitial lung
disease. After a >7-year mean follow-up, extra-articular outcomes and survival
were not different. ACPA-positive ASS patients showed an overlapping RA-ASS
syndrome, were at high risk of refractory erosive arthritis, and might experience
ASS flare when treated with antitumor necrosis factor drugs. In contrast, other
biologics such as anti-CD20 mAb were effective in this context, without worsening
systemic involvements.