The influence of CCPA and RF on the five-year outcomes in patients with early rheumatoid arthritisиве

Objective: to study the influence of CCPA and RF on 5-year outcomes in patients with early rheumatoid arthritis (RA). Subjects and methods. 204 patients with early RA (<2 years) according to American College of Rheumatology criteria included in the study from 2003 to 2007 (67,5% RF (+); 57% ACCP (+), 86,5% women aged 49 [40-58]). They were treated by DMARDs including the biologic therapy (24%) according the «tight-control» principle. Results. During the first four years the CCPA (+) (n=117) reliably had the higher level of the disease activity. While in the CCPA (-) group (n=87) mainly recorded the low activity and the remission. Baseline DAS28 (M±a) was 5,30±1,09 (compared 4,92±1,18), p<0,05. Froml to 5 years — 3,65±1,65 (3,18±1,24), 3,35±1,13 (2,99±1,11), 3,15±1,49 (2,65±1,11), 3,04±1,32 (2,58±1,09), p<0,05; 3,57±1,56 (3,32±2,41), p>0,05. Between RF (+) (n=138) and RF (-) (n=66) groups we did not find differences (p>0,05). Radiological damage in the CCPA(+) patients was more pronounced from the second year of the observation. Baseline, after 1 year SHS (M±o) was 19,7±10,5 (compared 15,1±8,9), 25,4±16,8 (20,3±12,2), p>0,05. From 2 to 5 years — 33,5±20,8 (25,3±14,2), 40,8±26,8 (31,9±20,2), 48,0±28,8 (37,2±22,6), 55,6±30,5 (44,0±24,5), respectively, p<0,05. This trend was determined in RF-positive patients. Conclusion. The CCPA- and RF-positive patients have the worst of 5-year radiological outcomes. CCPA-positive patients also have the worst clinical course during the first 4 years.