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Pretreatment serum levels of anti-cyclic citrullinated peptide antibodies are associated with the response to methotrexate in recent-onset arthritis
  1. K Visser,
  2. K N Verpoort,
  3. H van Dongen,
  4. S M van der Kooij,
  5. C F Allaart,
  6. R E M Toes,
  7. T W J Huizinga,
  8. A H M van der Helm-van Mil
  1. Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
  1. Miss K Visser, Leiden University Medical Centre, Department of Rheumatology, PO Box 9600, 2300 RC Leiden, The Netherlands; K.Visser{at}lumc.nl

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To direct individual treatment decisions in recent-onset rheumatoid arthritis (RA), predictors of treatment response to methotrexate (MTX) need to be identified. Disease activity at baseline, gender and genetic polymorphisms have already been found to be associated with the effect of MTX treatment, but the predictive value of autoimmune antibody status remains less clear.1 2 It has been shown, however, that both the presence and level of anti-cyclic citrullinated peptide antibodies (ACPA) are strongly associated with a worse disease course.3 Therefore, we investigated the potential predictive effect of levels of ACPA in ACPA-positive patients for the response to MTX treatment. As observations from our cohort and others indicate that ACPA levels decrease …

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