High-Titer Rheumatoid Factor is Associated with Worse Clinical Outcomes and Higher Needs for Advanced Therapies in Rheumatoid Arthritis Under Real-Life Conditions
Abstract Introduction Rheumatoid factor (RF) plays an important role in rheumatoid arthritis (RA) pathophysiology, yet the differential effects of varying RF titers remain understudied. We evaluated associations between different RF titers and clinical outcomes in long-standing RA. Methods This mult...
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Adis, Springer Healthcare
2024-12-01
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| Series: | Rheumatology and Therapy |
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| Online Access: | https://doi.org/10.1007/s40744-024-00730-w |
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| author | Victor Davi R. S. Oliveira Ana Paula M. G. Reis Claiton V. Brenol Ivânio A. Pereira Karina R. Bonfiglioli Letícia R. Pereira Manoel B. Bértolo Maria de Fátima L. C. Sauma Maria Fernanda B. R. Guimarães Paulo Louzada-Júnior Rina D. N. Giorgi Sebastião C. Radominski Licia Maria H. Mota Cleandro P. Albuquerque Geraldo R. Castelar-Pinheiro |
| author_facet | Victor Davi R. S. Oliveira Ana Paula M. G. Reis Claiton V. Brenol Ivânio A. Pereira Karina R. Bonfiglioli Letícia R. Pereira Manoel B. Bértolo Maria de Fátima L. C. Sauma Maria Fernanda B. R. Guimarães Paulo Louzada-Júnior Rina D. N. Giorgi Sebastião C. Radominski Licia Maria H. Mota Cleandro P. Albuquerque Geraldo R. Castelar-Pinheiro |
| author_sort | Victor Davi R. S. Oliveira |
| collection | DOAJ |
| description | Abstract Introduction Rheumatoid factor (RF) plays an important role in rheumatoid arthritis (RA) pathophysiology, yet the differential effects of varying RF titers remain understudied. We evaluated associations between different RF titers and clinical outcomes in long-standing RA. Methods This multicenter, cross-sectional study included adults meeting ACR/EULAR (2010) criteria for RA. Circulating RF titers and clinical-epidemiological characteristics were evaluated. Bivariate (Student’s t and chi-squared tests) tests and multiple logistic and linear regression analyses were conducted. Results We included 1097 participants; 78.7% had positive RF, with high titers (≥ 3 × the upper limit of normality) in 56.2%. Negative vs. low-positive RF groups performed similarly concerning all clinical outcomes, being subsequently aggregated as "non-high" RF group. High RF titers (compared to "non-high") were associated with tobacco use (odds ratio, OR [95% confidence interval, CI]: 2.04 [1.35, 3.08]; p < 0.001), multiraciality (OR [95% CI] 1.31 [1.03, 1.67]; p = 0.028, compared to White race), and higher body mass index (mean difference [95% CI] 0.69 [0.05, 1.33] kg/m2; p = 0.033). In multivariate analyses, high-titer RF was independently associated with higher disease activity (Clinical Disease Activity Index, CDAI: β = 2.44 [0.89, 3.99], p = 0.002), worse functional capacity (Health Assessment Questionnaire Disability Index, HAQ-DI: β = 0.112 [0.018, 0.205], p = 0.020); extra-articular manifestations (OR 1.48 [1.09, 2.00], p = 0.011); increased corticosteroid (OR 1.53 [1.19, 1.96], p = 0.001) and biological disease-modifying antirheumatic drugs (bDMARD) use (OR 1.41 [1.08, 1.84], p = 0.011). Conclusions High RF titers in long-standing RA were associated with worse disease activity, lower physical functionality, increased extra-articular manifestations, and higher usage of corticosteroids and bDMARDs. Comparing high vs. non-high RF titers (rather than positive vs. negative RF) seems more useful for evaluating the clinical effects of RF in RA. This approach should be considered in future studies of RF. |
| format | Article |
| id | doaj-art-70c07419318b4e71955b719926ccb6f3 |
| institution | Kabale University |
| issn | 2198-6576 2198-6584 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Rheumatology and Therapy |
| spelling | doaj-art-70c07419318b4e71955b719926ccb6f32025-01-26T12:52:09ZengAdis, Springer HealthcareRheumatology and Therapy2198-65762198-65842024-12-0112112313610.1007/s40744-024-00730-wHigh-Titer Rheumatoid Factor is Associated with Worse Clinical Outcomes and Higher Needs for Advanced Therapies in Rheumatoid Arthritis Under Real-Life ConditionsVictor Davi R. S. Oliveira0Ana Paula M. G. Reis1Claiton V. Brenol2Ivânio A. Pereira3Karina R. Bonfiglioli4Letícia R. Pereira5Manoel B. Bértolo6Maria de Fátima L. C. Sauma7Maria Fernanda B. R. Guimarães8Paulo Louzada-Júnior9Rina D. N. Giorgi10Sebastião C. Radominski11Licia Maria H. Mota12Cleandro P. Albuquerque13Geraldo R. Castelar-Pinheiro14Hospital Universitário de Brasília (HUB), Universidade de Brasília (UnB)UNICEUB, RheumatologyUniversidade Federal Do Rio Grande Do Sul, RheumatologyUniversidade do Sul de Santa Catarina-UNISUL Santa Catarina, RheumatologyUniversidade de São Paulo, RheumatologyUniversidade Do Estado Do Rio de Janeiro, RheumatologyUniversidade Estadual de Campinas, RheumatologyUniversidade Federal Do Pará, RheumatologyUniversidade Federal de Minas Gerais, RheumatologyUniversidade de São Paulo, RheumatologyHospital Do Servidor Público Estadual de São Paulo, RheumatologyUniversidade Federal Do Paraná, RheumatologyHospital Universitário de Brasília (HUB), Universidade de Brasília (UnB)Hospital Universitário de Brasília (HUB), Universidade de Brasília (UnB)Universidade Do Estado Do Rio de Janeiro, RheumatologyAbstract Introduction Rheumatoid factor (RF) plays an important role in rheumatoid arthritis (RA) pathophysiology, yet the differential effects of varying RF titers remain understudied. We evaluated associations between different RF titers and clinical outcomes in long-standing RA. Methods This multicenter, cross-sectional study included adults meeting ACR/EULAR (2010) criteria for RA. Circulating RF titers and clinical-epidemiological characteristics were evaluated. Bivariate (Student’s t and chi-squared tests) tests and multiple logistic and linear regression analyses were conducted. Results We included 1097 participants; 78.7% had positive RF, with high titers (≥ 3 × the upper limit of normality) in 56.2%. Negative vs. low-positive RF groups performed similarly concerning all clinical outcomes, being subsequently aggregated as "non-high" RF group. High RF titers (compared to "non-high") were associated with tobacco use (odds ratio, OR [95% confidence interval, CI]: 2.04 [1.35, 3.08]; p < 0.001), multiraciality (OR [95% CI] 1.31 [1.03, 1.67]; p = 0.028, compared to White race), and higher body mass index (mean difference [95% CI] 0.69 [0.05, 1.33] kg/m2; p = 0.033). In multivariate analyses, high-titer RF was independently associated with higher disease activity (Clinical Disease Activity Index, CDAI: β = 2.44 [0.89, 3.99], p = 0.002), worse functional capacity (Health Assessment Questionnaire Disability Index, HAQ-DI: β = 0.112 [0.018, 0.205], p = 0.020); extra-articular manifestations (OR 1.48 [1.09, 2.00], p = 0.011); increased corticosteroid (OR 1.53 [1.19, 1.96], p = 0.001) and biological disease-modifying antirheumatic drugs (bDMARD) use (OR 1.41 [1.08, 1.84], p = 0.011). Conclusions High RF titers in long-standing RA were associated with worse disease activity, lower physical functionality, increased extra-articular manifestations, and higher usage of corticosteroids and bDMARDs. Comparing high vs. non-high RF titers (rather than positive vs. negative RF) seems more useful for evaluating the clinical effects of RF in RA. This approach should be considered in future studies of RF.https://doi.org/10.1007/s40744-024-00730-wRheumatoid arthritisRheumatoid factorPrognosisDisease progressionCross-sectional study |
| spellingShingle | Victor Davi R. S. Oliveira Ana Paula M. G. Reis Claiton V. Brenol Ivânio A. Pereira Karina R. Bonfiglioli Letícia R. Pereira Manoel B. Bértolo Maria de Fátima L. C. Sauma Maria Fernanda B. R. Guimarães Paulo Louzada-Júnior Rina D. N. Giorgi Sebastião C. Radominski Licia Maria H. Mota Cleandro P. Albuquerque Geraldo R. Castelar-Pinheiro High-Titer Rheumatoid Factor is Associated with Worse Clinical Outcomes and Higher Needs for Advanced Therapies in Rheumatoid Arthritis Under Real-Life Conditions Rheumatology and Therapy Rheumatoid arthritis Rheumatoid factor Prognosis Disease progression Cross-sectional study |
| title | High-Titer Rheumatoid Factor is Associated with Worse Clinical Outcomes and Higher Needs for Advanced Therapies in Rheumatoid Arthritis Under Real-Life Conditions |
| title_full | High-Titer Rheumatoid Factor is Associated with Worse Clinical Outcomes and Higher Needs for Advanced Therapies in Rheumatoid Arthritis Under Real-Life Conditions |
| title_fullStr | High-Titer Rheumatoid Factor is Associated with Worse Clinical Outcomes and Higher Needs for Advanced Therapies in Rheumatoid Arthritis Under Real-Life Conditions |
| title_full_unstemmed | High-Titer Rheumatoid Factor is Associated with Worse Clinical Outcomes and Higher Needs for Advanced Therapies in Rheumatoid Arthritis Under Real-Life Conditions |
| title_short | High-Titer Rheumatoid Factor is Associated with Worse Clinical Outcomes and Higher Needs for Advanced Therapies in Rheumatoid Arthritis Under Real-Life Conditions |
| title_sort | high titer rheumatoid factor is associated with worse clinical outcomes and higher needs for advanced therapies in rheumatoid arthritis under real life conditions |
| topic | Rheumatoid arthritis Rheumatoid factor Prognosis Disease progression Cross-sectional study |
| url | https://doi.org/10.1007/s40744-024-00730-w |
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