ArticleArthritis research & therapy2014
Rheumatoid factor and anti-citrullinated protein antibody positivity, but not level, are associated with increased mortality in patients with rheumatoid arthritis: results from two large independent cohorts.
Article in Arthritis research & therapy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 61 citations in OpenAlex.
- Association of Seropositivity and Mortality in Rheumatoid Arthritis and the Impact of Treatment With Disease-Modifying Antirheumatic Drugs: Results From a Real-World Study.Arthritis care & research · 2020Trial
- Impact of Dual Rheumatoid Factor and Anticitrullinated Protein Antibody Seropositive, Single Seropositive, and Seronegative Rheumatoid Arthritis on Outcomes.Arthritis care & research · 2026Article
- The temporal mortality trend in seropositive and seronegative rheumatoid arthritis: a Danish population-based cohort study.EULAR rheumatology open · 2025Article
- Association of circulating levels of anti-CarP antibodies with disease activity, disability and radiological damage in rheumatoid arthritis patients: an open-label, observational study.Scientific reports · 2025Observational
- Real-world clinical outcomes and rationale for initiating abatacept as a first-line biologic for patients with anticitrullinated protein antibody- and rheumatoid factor-positive rheumatoid arthritis.Journal of comparative effectiveness research · 2024Article
- Long-term mortality in treated-to-target RA and UA: results of the BeSt and IMPROVED cohort.Annals of the rheumatic diseases · 2024Article
- Role of Inflammatory Cytokines in Rheumatoid Arthritis and Development of Atherosclerosis: A Review.Medicina (Kaunas, Lithuania) · 2023Review
- Different Clinical Relevance of Anti-Citrullinated Protein Antibodies in RA Patients.Doklady. Biochemistry and biophysics · 2023Article
- Data Mining Study on Prescription Patterns of Different Dosage Forms of Chinese Herbal Medicines for Treating and Improving Immune-Inflammatory Indices in Patients with Rheumatoid Arthritis.Chinese journal of integrative medicine · 2022Article
- Optical Biosensors for the Detection of Rheumatoid Arthritis (RA) Biomarkers: A Comprehensive Review.Sensors (Basel, Switzerland) · 2020Review
- Population-based estimates of humoral autoimmunity from the U.S. National Health and Nutrition Examination Surveys, 1960-2014.PloS one · 2020Article
- Economic Evaluation of Anticyclic Citrullinated Peptide Positivity in Rheumatoid Arthritis.Journal of managed care & specialty pharmacy · 2019Article
- Conceptual model for the health technology assessment of current and novel interventions in rheumatoid arthritis.PloS one · 2018Article
- Systemic treatment with resveratrol reduces the progression of experimental periodontitis and arthritis in rats.PloS one · 2018Article
- Altered glycan accessibility on native immunoglobulin G complexes in early rheumatoid arthritis and its changes during therapy.Clinical and experimental immunology · 2017Article
- Rheumatoid factor positivity increases all-cause and cancer mortality: a cohort study.Rheumatology international · 2017Article
- Pre-symptomatic autoimmunity in rheumatoid arthritis: when does the disease start?Seminars in immunopathology · 2017Review
- Rheumatoid factors do not predict cardiovascular disease and mortality in the general population in the Busselton Health Survey.BMC musculoskeletal disorders · 2017Article
- Epitope Specificity of Anti-Citrullinated Protein Antibodies.Antibodies (Basel, Switzerland) · 2017Review
- Anti-carbamylated protein autoantibodies associated with mortality in Spanish rheumatoid arthritis patients.PloS one · 2017Article
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
Abstract
introductionThis study aimed to investigate rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA) status and levels as predictors of mortality in two large cohorts of patients with early inflammatory arthritis (EIA).
methodsData from the Norfolk Arthritis Register (NOAR) and Leiden Early Arthritis Clinic (EAC) cohorts were used. At baseline, patients had demographic data and smoking status recorded; RF, ACPA and inflammatory markers were measured in the local laboratories. Patients were flagged with national death registers until death or censor date. Antibody status was stratified as negative, low or high positive by RF and ACPA levels individually. In addition, patients were grouped as seronegative, RF positive, ACPA positive or double antibody (RF and ACPA) positive. Cox regression models explored associations between antibody status and mortality adjusting for age, sex, smoking status, inflammatory markers and year of enrolment.
resultsA total of 4962 patients were included, 64% were female. Median age at onset was 56 (NOAR) and 54 (EAC) years. In NOAR and EAC respectively, 35% and 42% of patients were ACPA/RF positive. When antibody status was stratified as negative, low or high positive, there were no consistent findings between the two cohorts. Double antibody positivity was associated with excess mortality in both cohorts compared to seronegative patients: NOAR and EAC respective adjusted HR (95% confidence interval) 1.35 (1.09 to 1.68) and 1.58 (1.16 to 2.15).
conclusionsPatients with EIA who are seropositive for both RF and ACPA have increased mortality compared to those who are single positive or seronegative. Antibody level in seropositive patients was not consistently associated with excess mortality.
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