Patients with seronegative rheumatoid arthritis have a different phenotype than seropositive patients: A clinical and ultrasound study
IntroductionRheumatoid arthritis (RA) is an inflammatory disease whose clinical phenotype largely depends on the presence of rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA). Seronegative RA appears to be a less severe disease, but this remains controversial. This study aimed...
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Frontiers Media S.A.
2022-08-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.978351/full |
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| author | Natalia Carbonell-Bobadilla Carina Soto-Fajardo Luis M. Amezcua-Guerra Luis M. Amezcua-Guerra Ana Beatriz Batres-Marroquín Tania Vargas Adrian Hernández-Diazcouder Valentin Jiménez-Rojas Ana Cristina Medina-García Carlos Pineda Luis H. Silveira |
| author_facet | Natalia Carbonell-Bobadilla Carina Soto-Fajardo Luis M. Amezcua-Guerra Luis M. Amezcua-Guerra Ana Beatriz Batres-Marroquín Tania Vargas Adrian Hernández-Diazcouder Valentin Jiménez-Rojas Ana Cristina Medina-García Carlos Pineda Luis H. Silveira |
| author_sort | Natalia Carbonell-Bobadilla |
| collection | DOAJ |
| description | IntroductionRheumatoid arthritis (RA) is an inflammatory disease whose clinical phenotype largely depends on the presence of rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA). Seronegative RA appears to be a less severe disease, but this remains controversial. This study aimed to assess whether seronegative patients show a less severe disease than seropositive patients.MethodsA cross-sectional study was conducted on RA outpatients from a single center. Clinical activity scales, laboratory evaluations, and cardiovascular risk scores were assessed. Musculoskeletal ultrasound (US) examinations were performed.ResultsOne hundred and fourteen patients were enrolled. Eighty-five were seropositive (76% women) and 29 seronegative (93% women). Seropositive patients had a younger age at disease onset (43 ± 14 vs. 54 ± 11; p = 0.001) and used sulfasalazine (47 vs. 17%; p = 0.004) and glucocorticoids (36 vs. 10%; p = 0.007) more frequently. No differences in clinical activity scales and in 10-year cardiovascular risk were observed. Pathological US data were found more frequently in seropositive patients in the 2nd metacarpophalangeal (MCP) joint, both in grayscale (71 vs. 38%; p = 0.008) and in power Doppler (PD; 53 vs. 9%; p < 0.001); erosions (36 vs. 9%; p = 0.020) were also more frequent. We found greater severity of PD signals in the 2nd MCP and 3rd MCP joints of the seropositive patients, while synovitis severity was higher only in the 2nd MCP joints. The percentage of total joints with erosions (9 vs. 1%; p < 0.001) and 2nd MCP joints with erosions (25 vs. 7%; p < 0.001) was higher in seropositive patients.ConclusionRA patients show a differentiated phenotype according to their ACPA and RF status. In seronegative patients, RA begins later in life and has a lower requirement for antirheumatic therapies. On US evaluation, seropositive patients show more joint damage, especially in MCP joints. Despite this, long-term cardiovascular risk is similar among RA patients, regardless of their RF and ACPA status. |
| first_indexed | 2024-12-10T15:45:18Z |
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| id | doaj.art-de2d6bc7983f48f48624b890bafbff35 |
| institution | Directory Open Access Journal |
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| last_indexed | 2024-12-10T15:45:18Z |
| publishDate | 2022-08-01 |
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| spelling | doaj.art-de2d6bc7983f48f48624b890bafbff352022-12-22T01:42:58ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-08-01910.3389/fmed.2022.978351978351Patients with seronegative rheumatoid arthritis have a different phenotype than seropositive patients: A clinical and ultrasound studyNatalia Carbonell-Bobadilla0Carina Soto-Fajardo1Luis M. Amezcua-Guerra2Luis M. Amezcua-Guerra3Ana Beatriz Batres-Marroquín4Tania Vargas5Adrian Hernández-Diazcouder6Valentin Jiménez-Rojas7Ana Cristina Medina-García8Carlos Pineda9Luis H. Silveira10Department of Rheumatology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, MexicoRheumatology Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, MexicoDepartment of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, MexicoDepartment of Health Care, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, MexicoRheumatology Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, MexicoDepartment of Rheumatology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, MexicoDepartment of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, MexicoDepartment of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, MexicoRheumatology Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, MexicoRheumatology Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, MexicoDepartment of Rheumatology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, MexicoIntroductionRheumatoid arthritis (RA) is an inflammatory disease whose clinical phenotype largely depends on the presence of rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA). Seronegative RA appears to be a less severe disease, but this remains controversial. This study aimed to assess whether seronegative patients show a less severe disease than seropositive patients.MethodsA cross-sectional study was conducted on RA outpatients from a single center. Clinical activity scales, laboratory evaluations, and cardiovascular risk scores were assessed. Musculoskeletal ultrasound (US) examinations were performed.ResultsOne hundred and fourteen patients were enrolled. Eighty-five were seropositive (76% women) and 29 seronegative (93% women). Seropositive patients had a younger age at disease onset (43 ± 14 vs. 54 ± 11; p = 0.001) and used sulfasalazine (47 vs. 17%; p = 0.004) and glucocorticoids (36 vs. 10%; p = 0.007) more frequently. No differences in clinical activity scales and in 10-year cardiovascular risk were observed. Pathological US data were found more frequently in seropositive patients in the 2nd metacarpophalangeal (MCP) joint, both in grayscale (71 vs. 38%; p = 0.008) and in power Doppler (PD; 53 vs. 9%; p < 0.001); erosions (36 vs. 9%; p = 0.020) were also more frequent. We found greater severity of PD signals in the 2nd MCP and 3rd MCP joints of the seropositive patients, while synovitis severity was higher only in the 2nd MCP joints. The percentage of total joints with erosions (9 vs. 1%; p < 0.001) and 2nd MCP joints with erosions (25 vs. 7%; p < 0.001) was higher in seropositive patients.ConclusionRA patients show a differentiated phenotype according to their ACPA and RF status. In seronegative patients, RA begins later in life and has a lower requirement for antirheumatic therapies. On US evaluation, seropositive patients show more joint damage, especially in MCP joints. Despite this, long-term cardiovascular risk is similar among RA patients, regardless of their RF and ACPA status.https://www.frontiersin.org/articles/10.3389/fmed.2022.978351/fullrheumatoid arthritisultrasoundrheumatoid factoranti-citrullinated protein antibodiescardiovascular riskseronegative rheumatoid arthritis |
| spellingShingle | Natalia Carbonell-Bobadilla Carina Soto-Fajardo Luis M. Amezcua-Guerra Luis M. Amezcua-Guerra Ana Beatriz Batres-Marroquín Tania Vargas Adrian Hernández-Diazcouder Valentin Jiménez-Rojas Ana Cristina Medina-García Carlos Pineda Luis H. Silveira Patients with seronegative rheumatoid arthritis have a different phenotype than seropositive patients: A clinical and ultrasound study Frontiers in Medicine rheumatoid arthritis ultrasound rheumatoid factor anti-citrullinated protein antibodies cardiovascular risk seronegative rheumatoid arthritis |
| title | Patients with seronegative rheumatoid arthritis have a different phenotype than seropositive patients: A clinical and ultrasound study |
| title_full | Patients with seronegative rheumatoid arthritis have a different phenotype than seropositive patients: A clinical and ultrasound study |
| title_fullStr | Patients with seronegative rheumatoid arthritis have a different phenotype than seropositive patients: A clinical and ultrasound study |
| title_full_unstemmed | Patients with seronegative rheumatoid arthritis have a different phenotype than seropositive patients: A clinical and ultrasound study |
| title_short | Patients with seronegative rheumatoid arthritis have a different phenotype than seropositive patients: A clinical and ultrasound study |
| title_sort | patients with seronegative rheumatoid arthritis have a different phenotype than seropositive patients a clinical and ultrasound study |
| topic | rheumatoid arthritis ultrasound rheumatoid factor anti-citrullinated protein antibodies cardiovascular risk seronegative rheumatoid arthritis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.978351/full |
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