The New EULAR/ACR Classification ACPA Cutoff Levels Are Markers of Poor Radiological Outcome in Early Rheumatoid Arthritis

TL;DRAbstract

Background/Purpose: 
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\nThe recent proposed EULAR/ACR criteria for rheumatoid arthritis (RA) were established in part as a useful tool for identify and classified patients with early RA. The cutoff level of 3 times upper limit of normal (ULN) for ACPA antibodies have been pondered as an additional criteria item. Its value as prognostic marker in terms of radiological progression has not been established yet.
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\nAim: To analyzed the relation of high titers levels of ACPA according to EULAR/ACR criteria with radiological progression in a cohort of patients with early RA. 
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\nMethod: We conducted a prospective open-label study that included early RA patients from 2 referral centers. All patients were treated with a similar therapeutic protocol with DMARD. ACPA antibodies were determined by a second-generation anti-CCP2 ELISA test (Eurodiagnostica). We classified 3 populations according to ACPA titers: negative (<29 IU, using own cutoff), positive at low ti

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