Anti-advanced glycated end-products (anti-AGE) antibodies have been seen in patients with diabetes and cardiovascular disease, but some data indicates that, in RA, these antibodies may correlate with disease activity.
In evaluating nearly 1,200 patients enrolled in the Leiden early arthritis cohort, van der Woude et al. were able to measure anti-MAA and anti-AGE antibodies and perform statistical analyses looking at the prevalence and co-occurrence of antibodies, associations with genetic risk factors and associations with different phenotypes of disease.4
These researchers were able to show that anti-MAA and anti-AGE antibodies exist in patients with seropositive and seronegative RA and, at a lower prevalence, in patients with such conditions as psoriatic arthritis and crystalline arthritis. More specifically, these antibodies help identify a subgroup among patients with seronegative RA who are also positive for HLA-DRB1*03:01, have increased markers of inflammation and have shown some degree of radiographic progression. Although these antibodies are not a panacea, they may help sub-classify patients within disease categories.
In Sum
A great deal remains to be learned about disease pathogenesis, identifying patients at risk for progression of disease and knowing when to intervene in preclinical disease.
Jason Liebowitz, MD, completed his fellowship in rheumatology at Johns Hopkins University, Baltimore, where he also earned his medical degree. He is currently in practice with Skylands Medical Group, N.J.
References
- Emery P, Horton S, Dumitru RB, et al. Pragmatic randomised controlled trial of very early etanercept and MTX versus MTX with delayed etanercept in RA: The VEDERA trial. Ann Rheum Dis. 2020 Apr;79(4):464–471. [Published correction appears in Ann Rheum Dis. 2021 Mar;80(3):e45.]
- den Hollander N, Verstappen M, Sidhu N, et al. Hand and foot MRI in contemporary undifferentiated arthritis: In which patients is MRI valuable to detect rheumatoid arthritis early? A large prospective study [OP0083]. Ann Rheum Dis. 2022;81(suppl 1):55–56.
- Perniola S, Tolusso B, Elmesmari A, et al. Digital spatial profiling reveals distinct synovial tissue macrophage transcriptomic signature of sustained remission in rheumatoid arthritis patients at risk of disease flare after treatment cessation [OP0084]. Ann Rheum Dis. 2022;81(suppl 1):56.
- van Wesemael TJ, van den Beukel MD, Hoogslag ATW, et al. Antibodies against advanced glycation end-products (anti-age) distinguish patients with a more inflammatory profile and worse outcome in seronegative rheumatoid arthritis [OP0086]. Ann Rheum Dis. 2022;81(suppl 1):57.