ArticleArthritis research & therapy2017
The prevalence of ACPA is lower in rheumatoid arthritis patients with an older age of onset but the composition of the ACPA response appears identical.
Article in Arthritis research & therapy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 36 citations in OpenAlex.
- Comparing cost-utility of DMARDs in autoantibody-negative rheumatoid arthritis patients.Rheumatology (Oxford, England) · 2021Trial
- Anti-carbamylated protein antibodies and skin involvement in patients with systemic sclerosis: An intriguing association.PloS one · 2018Trial
- Clinical characteristics and long-term prognosis of anti-MDA5-positive dermatomyositis: a comparative study across age groups.Orphanet journal of rare diseases · 2026Article
- Clinical and Sonographic Pattern of Late-Onset and Early-Onset Rheumatoid Arthritis: Comparative Study.Clinical medicine insights. Arthritis and musculoskeletal disorders · 2026Article
- Diagnostic Performance of the Multi-Biomarker Disease Activity (MBDA) Score for Rheumatoid Arthritis in Patients with New-Onset Joint Symptoms: An Age-Stratified Retrospective Study.Open access rheumatology : research and reviews · 2026Article
- Dual rheumatoid factor and anti-cyclic citrullinated peptide antibody positivity affects the manifestations of rheumatoid arthritis.Singapore medical journal · 2025Article
- Exploring Anticitrullinated Antibodies (ACPAs) and Serum-Derived Exosomes Cargoes.Antibodies (Basel, Switzerland) · 2025Article
- Is rheumatoid arthritis always preceded by a symptomatic at-risk phase of arthralgia?RMD open · 2024Article
- Clinical Features of ACPA-Negative and ACPA-Positive Variants of Rheumatoid Arthritis.Doklady. Biochemistry and biophysics · 2024Article
- Increasing incidence of autoantibody-negative RA is replicated and is partly explained by an aging population.Annals of the rheumatic diseases · 2022Article
- Review
- Safety and Effectiveness of Biologic Disease-Modifying Antirheumatic Drugs in Older Patients with Rheumatoid Arthritis: A Prospective Cohort Study.Drugs & aging · 2020Article
- How thorough clinical observational studies on rheumatoid arthritis can have an impact on the field.Arthritis research & therapy · 2019Article
- A Swedish register-based, long-term inception cohort study of patients with rheumatoid arthritis - results of clinical relevance.Open access rheumatology : research and reviews · 2019Article
- Is Anti-Citrullinated Protein Antibody-Positive Rheumatoid Arthritis Still a More Severe Disease Than Anti-Citrullinated Protein Antibody-Negative Rheumatoid Arthritis? A Longitudinal Cohort Study in Rheumatoid Arthritis Patients Diagnosed From 2000 Onward.Arthritis care & research · 2018Article
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Authors and funding
12 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRheumatoid arthritis (RA) consists of two syndromes, one autoantibody-positive and one autoantibody-negative. Existing data on the relation between age of onset and prevalence of autoantibodies were conflicting. Therefore this multicohort study assessed the age of onset in relation to the presence of autoantibodies. The association with characteristics of the anti-citrullinated protein antibodies (ACPA) response was also explored.
methodsThe 1987 criteria-positive RA patients included in the Leiden EAC, BARFOT, ESPOIR, Umeå and Lund cohorts (n = 3321) were studied at presentation for age of onset and the presence of ACPA, rheumatoid factor (RF) and anti-carbamylated protein (anti-CarP) antibodies. Logistic regression analyses were performed; effect sizes were summarized in inverse-weighted meta-analyses. Within ACPA-positive RA, ACPA level was studied in all cohorts; ACPA isotypes, ACPA fine specificity and ACPA avidity index and clinical characteristics were studied in the Leiden EAC.
resultsFrom the age of 50 onward, the proportion of ACPA-negative RA patients increased with age in the five cohorts. Similar observations were made for RF and anti-CarP. The composition of the ACPA response did not change with increasing age of onset with respect to titer, isotype distribution, fine specificity and avidity index. With increasing age of onset, RA patients smoked less often, had higher acute phase reactants and more often had a sub(acute) symptom onset.
conclusionsData of five cohorts revealed that with older age of onset ACPA-negative RA is more frequent than ACPA-positive RA, while characteristics of ACPA-positive RA as judged by the composition of the ACPA response appeared not age dependent. Further biologic studies are needed to characterize the pathogenesis of ACPA-negative polyarthritis at older age and to promote personalized treatment decisions in ACPA-negative patients in daily practice.
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