Journal Article

POS0902 ANTI-SSA RO52 AND ANTI-RO60 AUTOANTIBODIES: ASSOCIATION WITH CLINICAL PHENOTYPES

Neto, A., Oliveira, N., Mazeda, C., Saraiva, A., Gomes Correia, A. M., Azevedo Abreu, P. M., Maduro, A., Jesus, D., Campinho Ferreira, C., Farinha, F., Barcelos, A., Abreu, C., Nicolau, R., Villanueva, I., Fraga, V., Inês, L., Silva-Dinis, J.

2023

Overview

BackgroundAnti-SSA autoantibodies can be differentiated according to their antigenic target proteins as anti-Ro60 (60 kDa) or anti-Ro52 (52 kDa). Anti-SSA(Ro60) are clearly associated with Connective Tissue Diseases (CTD), but the clinical significance of anti-SSA(Ro52) remains unclear.ObjectivesTo analyze the disease phenotype of patients with anti-Ro52 and/or anti-Ro60.MethodsMulticenter, cross-sectional study of anti-Ro52 and/or Ro60 positive patients followed at 10 Rheumatology centers from January 2018 until December 2021. Patients were categorised into 3 groups: group 1 (Ro52+/Ro60-); group 2 (Ro52-/Ro60+); group 3 (Ro52+/Ro60+). Antinuclear antibodies were evaluated by indirect immunofluorescence assay and further screened for anti-extractable nuclear antigen (ENA) antibodies. Demographics and clinical data were compared between the 3 groups, by patients’ medical chart review. Univariate analysis was performed using chi-square, Fisher’s exact or Kruskall-Wallis test. Subsequently, the Bonferroni test was used to identify intergroup differences (level of significance: p<0.0167). Univariate logistic regression was used to calculate the odds ratio with a 95% confidence interval (CI).ResultsWe included 776 patients [female: 83.1%; median age: 59 (46-71) years]. Groups 1, 2 and 3 comprised 31.1%, 32.6%, and 36.3% of the patients, respectively. Characteristics of the groups are presented in Table 1. Anti-Ro52 alone is more frequently associated with non-rheumatic diseases, older age, and men (p<0.05). Among patients with CTD, the diagnosis of systemic lupus erythematosus is 3 and 2 times more prevalent in groups 2 and 3, respectively, than in group 1 [OR 2.8 (95% CI 1.60, 4.97),p=<0.001; OR 2.2 (95% CI 1.28, 3.86), p=0.007]. In group 2, the diagnosis of undifferentiated connective tissue disease is more frequent than in the other groups. The presence of isolated Ro52+ is more frequently associated with inflammatory myositis than in group 2 [OR 0.09 (95% CI 0.01, 0.33), p=<0.001] or group 3 [OR 0.08 (95% CI 0.01, 0.29), p=<0.001]. Group 1 was also more frequently associated with arthritis (p=0.006), interstitial lung disease (p=0.002), and myositis (p=0.009).Table 1.Characteristics of the study population according to the groups of anti-SSA(Ro) positivity.Group 1 (n=241)Group 2 (n=253)Group 3 (n=282)pAge, median (IQR)64 (52-76)56 (44-67)57 (44-69)<0.001Female, n (%)185 (76.8)214 (84.6)246 (87.2)0.005Other anti-ENA, n (%) Anti-La24 (10)50 (19.8)114 (40.4)<0.001 Anti-RNP11 (4.6)23 (9.1)17 (6.0)0.115 Anti-Scl703 (1.2)4 (1.6)6 (2.1)0.146 Anti-Jo17 (3)1 (0.4)3 (1.1)0.070 Anti-Sm1 (0.4)7 (2.8)6 (2.13)0.098Anti-dsDNA11 (4.6)39 (15.4)37 (13.1)<0.001Anti-centromere12 (5)3 (1.2)6 (2.1)0.026Lupus anticoagulant10 (4.2)32 (12.7)23 (8.2)0.008Anti-cardiolipin8 (3.3)10 (3.9)23 (8.2)0.024Anti-β2 glycoprotein 16 (2.5)10 (3.9)10 (3.6)0.736Rheumatoid Factor46 (19.1)44 (17.4)81 (28.7)0.001Anti-CCP11 (4.6)15 (5.9)19 (6.7)0.327Non-rheumatologic disease, n (%)77 (32)35 (13.8)30 (10.6)<0.001 Infections11 (14.3)2 (5.7)1 (3.3)0.192 Neoplasms22 (28.6)3 (8.6)6 (20.0)0.057 Interstitial lung disease5 (6.5)4 (11.4)00.168 Other diseases46 (59.7)25 (71.4)22 (73.3)-Immune-mediated rheumatologic disease, n (%)164 (68.1)218 (86.2)252 (89.4)<0.001 Sjögren syndrome92 (56.1)88 (40.3)150 (59.5)<0.001 Systemic lupus erythematosus20 (12.2)61 (28)59 (23.4)0.001 Systemic sclerosis11 (6.7)7 (3.2)8 (3.2)0.150 Inflammatory myositis15 (9.2)2 (0.9)2 (0.8)<0.001 Rheumatoid arthritis18 (11)17 (7.8)16 (6.4)0.234 Undifferentiated connective tissue disease11 (6.7)35 (16.1)21 (8.3)0.004 Mixed connective tissue disease6 (3.7)6 (2.8)4 (1.6)0.406 Other diseases9 (5.5)8 (3.7)10 (4.0)-ConclusionAnti-Ro52+ alone is frequently found in patients with non-rheumatic diseases. In addition, anti-Ro52+ is also prevalent in patients with CTD and associated with clinical phenotypes that are different from anti-Ro60+.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

• Publisher: BMJ Publishing Group Ltd and European League Against Rheumatism,Elsevier B.V,Elsevier Limited
• Subject: Anti-DNA antibodies / Antinuclear antibodies / Arthritis / Autoantibodies / Cardiolipin / Connective tissue diseases / Diagnosis / Diagnostic tests / Diphosphatidylglycerol / Immunofluorescence / Inflammation / Lung diseases / Lupus / Mixed connective tissue disease / Myositis / Patients / Phenotypes / Population studies / Rheumatic diseases / Rheumatoid arthritis / Rheumatoid factor / Rheumatology / Scientific Abstracts / Sjogren's syndrome / Systemic lupus erythematosus / Systemic sclerosis