1. Rheumatoid Arthritis in the Women's Health Initiative: Methods and Baseline Evaluation.
- Author
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Kuller, Lewis H., Mackey, Rachel H., Walitt, Brian T., Deane, Kevin D., Holers, V. Michael, Robinson, William H., Sokolove, Jeremy, Chang, Yuefang, and Moreland, Larry W.
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GENETICS of disease susceptibility , *RHEUMATOID arthritis risk factors , *ANTIRHEUMATIC agents , *BIOMARKERS , *BLACK people , *BLOOD testing , *CONFIDENCE intervals , *HISPANIC Americans , *IMMUNOGLOBULINS , *LONGITUDINAL method , *POLYMERASE chain reaction , *RESEARCH funding , *SMOKING , *WHITE people , *WOMEN , *SECONDARY analysis , *DISEASE prevalence , *DESCRIPTIVE statistics - Abstract
Second-generation assays for anti-cyclic citrullinated peptide (anti-CCP), a highly sensitive and specific marker for rheumatoid arthritis (RA), have redefined the epidemiology of RA. In the Women's Health Initiative (WHI) RA study (2009–2011), we evaluated the prevalence of anti-CCP positivity among 15,691 (10.2% of 161,808) WHI participants aged 50–79 years who reported RA. Using stored baseline specimens, we measured serum anti-CCP, rheumatoid factor (RF), and antinuclear antibody in a defined sample of 9,988 of black, white, and Hispanic women. In a subset of women, we measured plasma cytokine levels and number of copies of the human leukocyte antigen (HLA)-DRB1 (HLA-DRB1) shared epitope in DNA by means of Luminex polymerase chain reaction typing (Luminex Corporation, Austin, Texas). We validated classification of probable clinical RA in 2 clinics as anti-CCP positivity or self-reported validated use of disease-modifying antirheumatic drugs (DMARDs). The prevalence of anti-CCP positivity was 8.1%, and the prevalence of RF positivity was approximately 16.0%. DMARD use including prednisone was reported by 1,140 (11.4%) participants (841 excluding prednisone) but by 57.5% of anti-CCP-positive women. The prevalence of 2 shared epitopes was also much higher for anti-CCP-positive women (18.2%, as opposed to only 5.5% for women with anti-CCP-negative DMARD-positive RA and 6.6% for anti-CCP-negative, RF-negative DMARD nonusers). Median cytokine levels were much higher for anti-CCP-positive/RF-positive women. Women with anti-CCP-positive RA and anti-CCP-negative RA had different characteristics with regard to HLA shared epitope, cigarette smoking, and inflammation (cytokines). [ABSTRACT FROM AUTHOR]
- Published
- 2014
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