Prevalence of anti-Ro antibodies in systemic sclerosis and their influence on the patient's clinical picture

Autores: Rebeca Rebouças Pereira, Ariadna Lorrane Romualdo, Mariane Martins Balduino, Thelma Larocca Skare

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Introduction: anti-Ro/SSA antibodies are some of the most commonly encountered antinuclear antibodies in daily clinical practice and are closely associated with several autoimmune diseases.

Objectives: to determine the prevalence of anti-Ro antibody in Brazilian patients with systemic sclerosis (SSc) and its influence on clinical and epidemiological features.

Materials and methods: retrospective chart review including patients with ≥9 points in the 2013 ACR/EULAR criteria for SSc, age of onset >16 years, and available anti-Ro antibody results.

Results: a total of 142 patients were included, predominantly female (11:1 ratio), 65.6% Caucasian, with a median age of 55 years and a median disease duration of 11 years. Limited SSc was the most common subtype. The median modified Rodnan skin score was 8. Raynaud's phenomenon was observed in 97.1% of patients, joint symptoms in 53.1%, gastrointestinal complaints in 66.6%, esophageal dysmotility in 69.5%, and interstitial lung disease in 63.5%. Anti-Ro antibodies were detected in 24.1% of patients. Anti-Ro positive patients showed a higher frequency of myositis (p=0.005), xerophthalmia (p=0.002), and secondary Sjögren’s syndrome (p<0.0001), along with lower skin thickening (p=0.002). Anti-La (p<0.0001) and anti-RNP (p<0.0001) antibodies were more frequent among anti-Ro positive patients, while anti-centromere antibodies were less frequent (p=0.02).

Conclusions: anti-Ro antibodies were present in approximately one-quarter of patients with systemic sclerosis and were associated with a higher prevalence of myositis, xerophthalmia, secondary Sjögren’s syndrome, and less skin involvement. Their presence also predicted positivity for anti-La and anti-RNP antibodies and absence of anti-centromere antibodies.