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Anti-cyclic citrullinated peptide antibody in psoriatic arthritis: a meta-analysis of its frequency and association with clinical features

Antizyklische zitrullinierte Peptid-Antikörper bei Psoriasis-Arthritis: eine Metaanalyse der Häufigkeit und Assoziation mit klinischen Merkmalen

Zeitschrift für Rheumatologie Aims and scope Submit manuscript

Abstract

Objective

This study aimed to investigate the frequency of the anti-cyclic citrullinated peptide (anti-CCP) antibody in patients with psoriatic arthritis (PsA) and to assess its associations with clinical features of this disease.

Methods

The Medline, EMBASE, and Cochrane databases were searched for studies that examined anti-CCP antibodies in patients with PsA. Meta-analyses of the frequency of the anti-CCP antibody in these patients and its association with polyarthritis, bone erosion, dactylitis, and enthesitis were then performed.

Results

Fourteen studies with a combined total of 3291 patients with PsA met the inclusion criteria for this meta-analysis. The pooled overall frequency of anti-CCP antibodies was 9.8% (95% confidence interval [CI] = 7.1–13.3, p < 0.001). Stratification by ethnicity showed that the anti-CCP antibody frequency was lower in Europeans than in non-Europeans (8.5% vs. 14.0%). The meta-analysis showed a significant association of the anti-CCP antibody with polyarthritis (odds ratio [OR] = 4.390, 95% CI = 2.312–8.333, p < 0.001), bone erosion (OR = 2.800, 95% CI = 1.921–4.081, p < 0.001), and dactylitis (OR = 1.958, 95% CI = 1.340–2.861, p < 0.001). However, there was no association between this antibody and enthesitis.

Conclusions

Our meta-analysis demonstrated that the overall frequency of the anti-CCP antibody was 9.8% in patients with PsA, and its presence was associated with increased risks of polyarthritis, bone erosion, and dactylitis, but not of enthesitis.

Zusammenfassung

Ziel

Das Ziel dieser Studie war es, die Häufigkeit der antizyklischen zitrullinierten Peptid(Anti-CCP)-Antikörper bei Patienten mit Psoriasis-Arthritis (PsA) zu untersuchen und deren Assoziation mit den klinischen Merkmalen dieser Erkrankung zu bewerten.

Methoden

Es erfolgte eine Datenbankrecherche in Medline, Embase und Cochrane nach Studien, die Anti-CCP-Antikörper bei Patienten mit PsA untersucht haben. Anschließend wurde eine Metaanalyse bezüglich der Häufigkeit von Anti-CCP-Antikörpern bei diesen Patienten und deren Assoziation mit Polyarthritis, Knochenerosion, Daktylitis und Enthesitis durchgeführt.

Ergebnisse

Insgesamt 14 Studien mit zusammen insgesamt 3291 Patienten mit PsA erfüllten die Einschlusskriterien dieser Metaanalyse. Die gepoolte Gesamt-Häufigkeit der Anti-CCP-Antikörper lag bei 9,8 % (95 % Konfidenzintervall [KI] = 7,1–13,3; p  < 0,001). Die Stratifizierung nach Ethnizität zeigte, dass die Häufigkeit von Anti-CCP-Antikörpern bei Europäern geringer war als bei Nichteuropäern (8,5 % vs. 14 %). Die Metaanalyse zeigte einen signifikanten Zusammenhang der Anti-CCP-Antikörper mit Polyarthritis (Odds-Ratio [OR] = 4,390; 95 % KI = 2,312–8,333; p  < 0,001), Knochenerosion (OR = 2,800; 95 % KI = 1,921–4,081; p  < 0,001) und Daktylitis (OR = 1,958; 95 % KI = 1,340–2,861; p  < 0,001). Es gab jedoch keine Assoziation zwischen Antikörpern und Enthesitis.

Schlussfolgerung

Die Metaanalyse zeigte, dass die Gesamt-Häufigkeit der Anti-CCP-Antikörper bei Patienten mit PsA 9,8 % betrug und deren Auftreten mit einem erhöhten Risiko für Polyarthritis, Knochenerosion und Daktylitis einhergeht, aber kein erhöhtes Risiko für eine Enthesitis besteht.

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Acknowledgements

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Correspondence to Young Ho Lee MD, PhD.

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K.Y. Kim and Y.H. Lee declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

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U. Müller-Ladner, Bad Nauheim

U. Lange, Bad Nauheim

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Kim, K.Y., Lee, Y.H. Anti-cyclic citrullinated peptide antibody in psoriatic arthritis: a meta-analysis of its frequency and association with clinical features. Z Rheumatol 79, 397–403 (2020). https://doi.org/10.1007/s00393-019-0666-z

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  • DOI: https://doi.org/10.1007/s00393-019-0666-z

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