association between anti-cyclic citrullinated peptide (ccp) antibody titers and oral prednisolone tapering in newly diagnosed rheumatoid arthritis: a retrospective cohort study on methotrexate efficacy

Background: this study examined the association between baseline anti-cyclic citrullinated peptide (anti-ccp) titers and oral prednisolone tapering in patients with newly diagnosed rheumatoid arthritis (ra), emphasizing methotrexate (mtx) efficacy. methods: a retrospective cohort of 230 ra patients from mashhad, iran (2019 - 2021) was stratified by prednisolone use (reduction/discontinuation vs. stable) and anti-ccp titers [high: > 3 × upper limit of normal (uln); low: 1 - 3 × uln; normal: ≤ 1 × uln]. the mtx dose was 10 - 15 mg/week. c-reactive protein (crp) was measured via immunoturbidimetry. logistic regression was used to assess the relationship between anti-ccp titers and prednisolone reduction/discontinuation, adjusting for potential confounders such as age, sex, and medication use. a p-value < 0.05 was considered statistically significant. results: 36.5% (84/230) of patients reduced/discontinued prednisolone. the mtx users had higher odds [odds ratio (or): 3.022, 95% ci: 1.82 - 5.01, p < 0.001]. no association with anti-ccp titer was observed (p = 0.484). however, logistic regression revealed that patients using mtx (as the reference group) had a significantly higher likelihood of reducing/discontinuing prednisolone (or: 3.022, p < 0.001). conclusions: this study found no significant relationship between baseline anti-ccp titers and the reduction/discontinuation of prednisolone in ra patients after 18 months of follow-up. however, mtx use was independently associated with a higher likelihood of reducing or discontinuing prednisolone, suggesting potential implications for treatment strategies in ra management.