“There is an increased mortality and decreased life span if you have this antibody,” Dr. Moreland says. “It’s probably related to cardiovascular factors. That’s a whole new area of research to understand what is causing cardiovascular features to come on early in these patients, and cause them to have heart attacks and strokes.”

Because the data used in this study were collected as early as 1993, Dr. Moreland says it’s important to stress that many participants were not taking treatments that are available today, including the highly successful biologic class of drugs..

“Today for patients with early RA, I will start them very quickly on some very good drugs and I will try to put them into remission,” Dr. Moreland says. “We are hoping what we are doing now has impacted this problem – although we won’t know until we follow patients for 10 or 15 years.”

Terry Moore, MD, director of rheumatology at St. Louis University in Missouri has published more than two dozen research papers on anti-CCP. He says this latest study is a good reminder for rheumatologists and their postmenopausal women patients to make sure they’re working to improve all the other modifiable risk factors associated with RA that they can.

“Patients need to get to an ideal weight, not smoke and make sure they have no hypertension, and we need to monitor all their risk factors and make sure they are active,” Dr. Moore says. “One-and-a-half to twofold increased mortality risk is not a great increase. It just tells us that you want to get these patients on [medications] early to try and reduce the inflammation as quickly as possible, and over time that may help reduce mortality, too.”

Patients aren’t generally screened for anti-CCP antibodies in the United States right now, says Dr. Moreland, noting that it is used more as a research tool. “What we’ve learned is that patients who have RA have these antibodies for several years before they develop the disease. But even if you have the antibody, it doesn’t mean you will develop RA and it doesn’t tell you when,” Dr. Moreland explains.

He says there is still much to learn about the anti-CCP antibody and believes future research will help doctors better understand why it increases mortality risk. “Now the question is, ‘Why? What is it doing?’” Dr. Moreland says. “We have a lot more work to do to figure that out.”