Anti-citrullinated peptides antibodies in systemic sclerosis: Meta-analysis of frequency and meaning |
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Authors: | Guillaume Laustriat Adeline Ruyssen-Witrand Arnaud Constantin Thomas Barnetche Daniel Adoue Alain Cantagrel Yannick Degboé |
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Affiliation: | 1. Centre de rhumatologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Dr-Baylac, TSA 40 031, 31059 Toulouse cedex 9, France;2. Pharmaco-épidémiologie, évaluation de l’utilisation et du risque médicamenteux, Inserm UMR 1027, faculté de médecine, 37, allées Jules-Guesde, 31000 Toulouse, France;3. CPTP, Inserm UMR 1043, CHU Purpan, BP 3028, 31024 Toulouse cedex 3, France;4. Service de rhumatologie, FHU Acronim, CHU Pellegrin, place Amélie-Raba-Léon, 33000 Bordeaux, France;5. Service d’immunologie clinique, IUCT, oncopole, CHU de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France |
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Abstract: | ObjectivesDiagnosis of systemic sclerosis (SSc) is partially determined by the presence of specific autoantibodies often associated with specific clinical features. Recent studies report the presence of ACPA in SSc. We aimed to evaluate the prevalence of ACPA in SSc and to assess their influence on clinical presentation of SSc.MethodsA systematic literature search was performed using PubMed and Cochrane databases’ publications between 1999 and March 2017. Search terms were: “systemic sclerosis [MeSH] AND (ACPA OR anti-CCP OR rheumatoid factor OR cohort OR value diagnostic)”. In a first step, we selected cohorts with > 50 SSc patients with ACPA identification, for ACPA frequency determination. In a second step, we included studies that analysed clinical profiles according to ACPA status. Meta-analyses were performed when at least two studies were available.ResultsFirst, we identified 13 observational studies with a total of 1231 SSc patients. The mean prevalence of ACPA in SSc was 9.2%. Secondly, we identified nine studies reporting clinical aspects according to ACPA status. Our meta-analyses showed a significant association between ACPA positivity and the presence of arthritis (odds ratio (OR) = 22.48 [10.71–47.21]), joint erosions seen on X-rays (OR = 14.79 [6.38–34.28]), pulmonary fibrosis (OR = 2.75 [1.21–6.24]), oesophagus involvement (OR = 2.72 [1.05–7.07]), and diffuse skin involvement (OR = 2.21 [1.21–4.03]).ConclusionsThe prevalence of ACPA in scleroderma is 9.2%. Our meta-analysis shows an increased risk for erosive arthritis, pulmonary fibrosis, oesophagus involvement and diffuse skin involvement, in patients with ACPA-positive SSc. ACPA should be systematically included in SSc assessment. |
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Keywords: | Systemic sclerosis Anti-citrullinated protein antibodies Risk factor Arthritis Erosion Lung fibrosis |
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