AB0885 Anti-Cyclic Citrullinated Peptide (ANTI-CCP) Antibodies in Polyarticular Juvenile Idiopathic Arthritis at Adulthood
Authors: C. Frantz, R. Bazeli, M. Elhai, A. Feydy, C. Deslandre, J. Wipff
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Several studies have already focused on anti-cyclic citrullinated peptide (anti-CCP) antibodies in juvenile idiopathic arthritis (JIA). Results of these studies showed that anti-CCP were associated with polyarticular sub-type (pJIA) and more severe disease, especially for structural damages. However, these studies analysed global JIA without focusing on the polyarticular form and especially on rheumatoid factors (RF) positive pJIA. <h3>Objectives</h3> Determine the prevalence of anti-CCP and evaluate their clinical and radiographic significance in polyarticular JIA at adulthood. <h3>Methods</h3> Anti-CCP antibodies were determined in a large cohort of polyarticular form of JIA at adulthood. Following demographic and clinical data were collected: sex, age at diagnostic, medical treatments (corticosteroids, DMARDs and biotherapies), history of surgery, number of synovitis and C-reactive protein at the last medical visit. Rheumatoid factors (RF) and antinuclear antibodies (AAN) have been collected. Radiographic damages were evaluated by the Sharp Van Der Heijde score. <h3>Results</h3> 56 patients with polyarticular form of JIA, fulfilling the ILAR criteria, persisting at adulthood were included with mean age of 25±8.1 years and mean disease duration of 14.3±8.7 years. Antibodies status (anti-CCP, RF and AAN) was performed after a mean of 11.6±9 years after the diagnosis. 29/56 (52%) patients were anti-CCP positive. Anti-CCP positive pJIA had a significant association with presence of RF (97% vs 26%, p&lt;0.0001), a higher use of biotherapies (86% vs 70%, p=0.02, OR=4.3 [1.2-15.8]) and were older at diagnosis (13±3.4 vs 7.6±4.9, p=0.00001) than anti-CCP negative patients. No differences have detected for sex, presence of antinuclear antibodies, synovitis, CRP, Corticosteroids, DMARDs and surgery. Radiographic damages were similar between the two sub-groups for erosion (16.2±21.3 vs 14.8±28.3), joint space narrowing (24.3±29.3 vs 23.8±34.9) and total scores (40.4±46.8 vs 38.7±61.8). In the sub-group of RF positive pJIA (n=35), 28 were anti-CCP positive and 7 negative. No differences for sex, clinical data, medical treatments, surgery and radiographic damages have been detected. <h3>Conclusions</h3> In this large cohort of polyarticular JIA patients at adulthood, anti-CCP antibodies are associated with a higher need of biotherapies but not with a more structural radiographic severe disease. A small sub-group of patients were RF+ and anti-CCP-. Comparison of RF+ and anti-CCP+ and RF+ and anti-CCP- patients showed that anti-CCP did not seem to bring more information as RF but a larger cohort will be necessary to confirm these results. Finally, our results suggest that polyarticular JIA patients evolving at adulthood are independent of anti-CCP antibodies status at the difference of the pJIA in childhood in which anti-CCP status remains a poor prognostic factor. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.5319