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Another autoantibody that helps in making diagnosis of early RA is highlight of this issue. Brink M and his team from Sweden studied anti-carbamylated protein (anti-CarP) antibodies in samples taken from individuals who subsequently developed RA before and after onset of symptoms and compared them to previously analyzed antibodies against citrullinated peptides (ACPA specificities) and anti-CCP2.

A total of 252 individuals, with 423 samples from before onset of symptoms of RA, and 197 population controls were identified, 192 of them were also sampled at the time of diagnosis. All samples were analysed for anti-CarP IgG and anti-CCP2 antibodies using ELISAs., The concentration of anti-CarP antibodies was significantly increased in the pre-symptomatic individuals compared with controls (P <0.001) and also increased significantly after disease onset (P <0.001).

The sensitivity for anti-CarP antibodies in the pre-symptomatic individuals was 13.9% (95% CI: 11 to 17.6) and 42.2% (95% CI: 35.4 to 49.3) following development of RA. Anti-CarP antibody positivity was found in 5.1% to 13.3% of individuals negative for anti-CCP2 or ACPA. Presence of anti-CarP antibodies was significantly related to radiological destruction at baseline, at 24 months and also to radiological change (P <0.05, all).

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Banwari Sharma
Editor, IRA e-Newsletter