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P22 Anti-carbamylated protein antibodies in systemic lupus erythematosus: clinical and serological associations
  1. Micaela Fredi1,2,
  2. Ilaria Cavazzana1,
  3. Francesco Poiatti1,
  4. Michele Boldrini1,
  5. Silvia Piantoni1,2,
  6. Rajesh Kumar1,
  7. Roberta Ottaviani1,2,
  8. Angela Tincani1,2 and
  9. Franco Franceschini1,2
  1. 1Rheumatology and Clinical Immunology Unit, ASST Spedali Civili, Brescia
  2. 2Dept. of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy


Background/Purpose Anti-carbamylated protein antibodies (anti-CarP) have been described not only in Rheumatoid arthritis but in other systemic autoimmune diseases. Recently, they have been reported in different cohorts of Systemic Lupus Erythematosus (SLE) with a prevalence of 9–28%1–4 in patients selected with arthritis/arthralgias. Anti-CarP have been proposed as a marker of erosive arthritis in SLE.4 The aim was to assess the prevalence of anti-CarP in SLE patients from a single center cohort and their association to clinical and laboratory data.

Methods Serum anti-CarP levels were evaluated using a home-made ELISA (nv<340 AU/ml). Clinical data were obtained from clinical charts.

Results Complete clinical and serological data were available for 314 consecutive patients: 85 (27%) positive and 229 (73%) negative. No association was found among CarP+ and arthritis/arthralgias. CarP+ patients presented an earlier disease onset compared with CarP- (mean 28±11vs32±14.7,p=0.001), a trend towards a higher prevalence of xerophtalmia (36% vs 26.5%, p=0.075;OR:1.62,95%CI:0.95–2.75) and extractable nuclear antigen positivity (67% vs 54%,p=0.064;OR:1.65,95%CI:0.97–2.8). Interestingly, patients anti-CarP+ less frequently experienced class IV glomerulonephritis (12%vs 21.8%,p=0.05;OR:0.53,95%CI:0.26–1.08). Fifty-six patients evaluated were treated with anti-Blys therapy and longitudinally sera were available (T0,T6,T12). At baseline anti-CarP were positive in 10 (17.8%) and titre significantly decreased at T6 (p=0.006) and T12 (p=0.01). Negative seroconversion was observed in 7/10 sera.

Conclusions The prevalence of anti-CarP antibodies found in our unselected cohort is in line with to what previously reported. In our hands, anti-CarP antibodies seems to identify a less severe form of SLE, with less kidney involvement and probably in overlap with Sjogren disease. Further studies are needed in order to be able to identify a possible role for this autoantibody.


  1. Ziegelasch M,et al.Arthritis Res and Ther 2016;18:289.

  2. Nakabo S,et al J Rheumatol 2017

  3. Pecani A,et al. Arthritis Res Ther 2016; 18: 276.

  4. Ceccarelli F,et al. Arthritis Res Ther 2018; 20:126.

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