Introduction:

Rheumatoid arthritis (RA) is a chronic and inflammatory disease characterized by presence of autoantibodies. Objective: to develop Cuban immunoassays to determine antibodies and evaluate the usefulness of antibodies against a citrullinated fibrinogen peptide for diagnosis and therapeutic clinical assessment of patients with RA.

Methods:

A case-control study was conducted. Participants were 162 patients with RA, 112 patients with other diseases and 50 healthy individuals. The analytical and diagnostic performance of a novel immunoassay was evaluated to determine antibodies against a citrullinated fibrinogen peptide designed by computer, rheumatoid factor and antiqueratin antibodies. Commercial rheumatoid factor antibodies, second generation citrullinated peptides, mutated citrullinated vimentin, carbamylated vimentin and antiqueratin were determined by commercial immunoassays. A longitudinal study was conducted on 60 patients with early RA. Antibodies, C-reactive protein, erythrocyte sedimentation rate, activity index and response to methotrexate after six months were determined.

Results:

Three immunoassays were introduced into practice. The diagnostic performance of the antibodies against the citrullinated fibrinogen peptide was superior to the most commonly used commercial immunoassays, with a lower cost per patient (5,52 CUC) than the second-generation antibodies (14,00 CUC). Patients with these antibodies had a higher risk for greater activity (risk = 0,96; p = 0,0424) and low response to treatment (risk = 0,82; p = 0,0402). The determination of antibodies against a novel citrullinated fibrinogen peptide has lower cost and great utility for the diagnosis and therapeutic clinical evaluation in RA.

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