Reported in 70 , 73 , and 76 of patients, respectively, and anti-CCP2 status, in 73 .Serial serum measurements of the different autoantibodies were made in the majority of patients at baseline and during the follow-up. In 56 patients, all four tests were available at baseline and at 1 and 2 years of follow-up. CFFCP status remained stable in most patients during the follow-up, but some patients became positive (2.3 to 12.8 ) and even more became negative (12.2 to 21.7 ). Negative conversion occurred mainly in patients with serum levels just above the normal range for both the CCFCP test and the commercialAnti-CFFCP antibodies and disease activity At baseline, disease activity measured by the DAS28 score was similar in patients with and without anti-CFFCP1, antiCFFCP2, and anti-CFFCP3 antibodies and those with and without anti-CCP2 antibodies. The DAS28 score decreased significantly in positive and negative patients, but differences were not significant at 1 and 2 years (Figure 2). No correlation between the variations in anti-CFFCP antibody titers and different measures of disease activity at 1 and 2 years was found, except in the case of anti-CFFCP3 titer and the swollen-joint count at 2 years (P = 0.04). The change in DAS28 at 2 years (P = 0.04) and change in the swollen-joint count at 1 and 2 years (P = 0.03 and P = 0.001) correlated with variations of the CCP2 test at 2 years, but the correlations disappeared after Bonferroni correction. Anti-CFFCP antibodies and radiographic damage Baseline radiographic damage measured by the Larsen score was significantly higher in patients with CFFCP1 antibodies than in those without. Higher scores were also observed in patients with positive anti-CFFCP2, anti-CFFCP3, and antiCCP2 status than those with negative status, but these differences were not statistically significant. After 24 months, significantly higher Larsen scores were observed only for positive anti-CFFCP1 status versus negative status, although a clear nonsignificant trend was observed also for positive anti-CCP2 status (Figure 3). Mean Larsen scores at baseline and at 2 years were higher in the small group of patients negative for anti-CCP2 antibodies and positive for anti-CFFCP1 antibodies (n = 8; mean ?SD, 1.6 ?2.2 and 6.4 ?10.9, respectively) than were those observed in patients negative for both autoantibodies (n = 22; mean ?SD, 0.4 ?1.2 and 3.0 ?6.0, respec-Page 5 of(page number not for citation purposes)Arthritis Research TherapyVol 11 NoSanmart?et al.FigureCFFCP and changes in the disease-activity score DAS28 during the 2 years of follow-up in early RA patients who PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/16989806 are positive and negative for antiComparativeanti-CCP2 at baseline CFFCP and anti-CCP2 at baseline. Anti-CFFCP1 (n = 101), anti-CFFCP2 Atazanavir (n = 98), anti-CFFCP3 (n = 98), and anti-CCP2 (n = 109). Mean values are presented. *P < 0.05.tively) and similar to those observed in patients positive for both autoantibodies (n = 65; mean ?SD, 1.6 ?3.1 and 7.0 ?10.9, respectively).DiscussionThis study analyzed the diagnostic and prognostic properties of three new ELISA tests for RA to detect ACPA. These noncommercial assays, which use synthetic chimeric cyclic citrullinated peptides from filaggrin and the chain of fibrin as antigenic substrates, showed a high sensitivity and specificity for RA in comparison with healthy controls and those with other chronic diseases. Furthermore, in a group of early RA patients, these antibodies were associated with poor radiographic out.