Risk Factors for Developing Rheumatoid Arthritis in Patients With Undifferentiated Arthritis and Inflammatory Arthralgia

Abstract

Currently, there is an increasing interest in treating patients at risk of rheumatoid arthritis (RA) to prevent the development of this chronic disease. In this sense, research has focused attention on the early identification of predictive factors of this disease. Autoantibodies and markers of systemic inflammation can be present before clinical arthritis and RA development. So, the phase of inflammatory arthralgia preceding clinical arthritis is an important part of the window of opportunity and, starting treatment might prevent progression to chronic arthritis. Additionally, the early diagnosis and treatment initiation, in patients with inflammatory arthritis at risk of persistence and/or erosive progression, are fundamental because may allow optimal clinical responses, better chances of achieving sustained remission, preventing irreversible organ damage and optimizing long-term outcomes. This review aims to give an overview of clinical risk factors for developing RA, both in suspected arthralgia and in undifferentiated arthritis. Besides taking into consideration the role of serological markers (immunological and acute phase reactants) and clinical features assessed at consultation such as: articular affection and patient's clinical perception. Other features as sociodemographic and environmental factors (lifestyle habits, microbiota, periodontal disease among others), have been included in this revision to give an insight on strategies to prevent development of RA and/or to treat it in early stages.

The polyunsaturated fatty acid profile in erythrocyte cell membranes among group of Egyptian rheumatoid arthritis patients

“…The risk of RA was shown to be reduced in individuals who consumed more fatty fish (>8 g fat/100 g fish) than in those who consumed less fatty fish (between 3 and 7 g fat/100 g fish) in a Danish prospective cohort study. Women who consumed more than 0.21 g/day of long-chain n-3 polyunsaturated fatty acids had a 35% decreased chance of having RA [14].…”

A Roadmap for Investigating Preclinical Autoimmunity Using Patient-Oriented and Epidemiologic Study Designs: Example of Rheumatoid Arthritis

“…The Colombia-based study found thar anti-CarP antibodies are more often observed in FDRs than healthy controls ( 117 ). It is important, however, the note that other studies did not find that this AMPA’s presence added additional risk for developing RA ( 115 ).…”

“…Subjects in this cross-sectional study were 18 years or older ( 114 ). This is a critical study population because the link between genetics, and RA development have been heavily considered due to the increased conversion to RA diagnosis among FDRs ( 115 ). Previous studies have estimated the increase in risk of developing RA to be approximately 4 times higher in FDRs of people diagnosed with RA than in individuals that are not FDRs ( 116 ).…”

Advancement in understanding the role of ferroptosis in rheumatoid arthritis

“…Risk factors for RA include smoking, silica exposure, disorders of periodontal and intestinal microbiota, etc. ( Novella-Navarro et al, 2021 ). The immune cells and inflammatory mediators associated with RA mainly include T cells, B cells, macrophages, monocytes, interleukins (ILs), tumor necrosis factor-α (TNF-α), etc.…”