A prospective approach to investigating the natural history of preclinical rheumatoid arthritis (RA) using first‐degree relatives of probands with RA

Abstract

Objective. To describe a large, multicenter prospective cohort study of first-degree relatives (FDRs) of probands with rheumatoid arthritis (RA), and outline the use of such a study in investigating the natural history of RA development. Methods. A total of 1,058 FDRs, none of whom met the American College of Rheumatology criteria for RA, were enrolled in a prospective study investigating genetic and environmental influences on the development of RA-related autoimmunity. Demographic, epidemiologic, genetic, autoantibody, and physical examination data from the initial study enrollment visit were described for these FDRs, and the relationship was examined between genetic factors, autoantibodies, inflammation, and joint disease.

Characterising arthralgia in the preclinical phase of rheumatoid arthritis using MRI

“…Whether or not a patient had CSA was determined at the first visit before any blood tests had been performed, and thus did not depend on the knowledge of the autoantibody status of the patient. This concept is different from that used in studies on the preclinical phase that select persons with an increased risk of RA because of the presence of autoantibodies7 or a positive family history 27. The advantage of the current CSA approach is that it is in line with clinical practice where patients present with certain symptoms and the decision to perform additional investigations is based on the clinical presentation.…”

Relationship between air pollution and positivity of RA-related autoantibodies in individuals without established RA: a report on SERA

“…FDRs received an initial examination confirming that they did not have RA meeting the 1987 American College of Rheumatology (ACR) criteria,15 and subsequent follow-up visits to collect blood for measurement of the following autoantibodies: anticyclic citrullinated peptide (anti-CCP2), RF by nephelometry and RF isotypes such as immunoglobulin (Ig) A, G and M (RF-IgA, RF-IgG, RF-IgM), described previously 16. We evaluated the following outcomes: RF positivity, high-risk autoantibody profile (HRP) positivity, which was defined as positivity for anti-CCP2 and/or two RF isotypes, and a measurement of inflammation, high-sensitivity C-reactive protein (hsCRP) positivity, as described previously 16. We were unable to investigate anti-CCP2 alone as we had only 28 anti-CCP2 positives; however, HRP was found to be 74% sensitive and 98.6% specific for RA, which was comparable to anti-CCP2 4.…”

Genética da artrite reumatoide: é necessário um novo impulso em populações latino‐americanas

“…16 Os alelos HLA-DRB1 com EC estão presentes em 64 a 70% dos pacientes com AR e em 55% dos seus parentes de primeiro grau; essa frequência é significativamente superior à observada em populaç ões-controle (35,8%). 26,27 Em pacientes com AR ACPA-positivos, 80% têm pelo menos um EC, enquanto 49% dos pacientes com AR ACPA-negativos têm EC. Essa interação entre os fatores de risco genéticos e a presença de autoanticorpos aumenta o risco de parentes de primeiro grau de pacientes com AR desenvolverem AR.…”

“…Essa interação entre os fatores de risco genéticos e a presença de autoanticorpos aumenta o risco de parentes de primeiro grau de pacientes com AR desenvolverem AR. 27,28 A hipótese dos EC permanece controversa, porque sugere a existência de um peptídeo autoantigênico que ainda não foi identificado. Diversas outras doenç as, como a diabete tipo I, a artrite psoriática, o lúpus, a leucemia linfoide crônica de iní-cio precoce e outras condiç ões, e essa 29 promiscuidade são incongruentes com os princípios da teoria da apresentação de antígeno restrita ao MHC.…”