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Extended report
Dissection of the FCGR3A association with RA: increased association in men and with autoantibody positive disease
  1. James I Robinson1,
  2. Jennifer H Barrett1,
  3. John C Taylor1,
  4. YEAR Consortium2,
  5. Marc Naven1,
  6. Diane Corscadden1,
  7. BRAGGSS3,
  8. Anne Barton4,
  9. Anthony G Wilson5,
  10. Paul Emery1,
  11. John D Isaacs6,
  12. Ann W Morgan1
  1. 1NIHR-Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK
  2. 2Yorkshire Early Arthritis Register (YEAR) Consortium
  3. 3Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate (BRAGGSS)
  4. 4arc-Epidemiology Unit, Stopford Building, The University of Manchester, Manchester, UK
  5. 5School of Medicine and Biomedical Sciences, The University of Sheffield, Sheffield, UK
  6. 6Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, UK
  1. Correspondence to Ann W Morgan, NIHR-Leeds Musculoskeletal Biomedical Research Unit, St James's University Hospital, Leeds Institute of Molecular Medicine, University of Leeds, Leeds LS9 7TF, UK; a.w.morgan{at}


Objectives Genome-wide association studies in rheumatoid arthritis (RA) have failed to examine the FCGR gene cluster because of the confounding effects of segmental duplication. This study aimed to replicate previous candidate gene studies that had identified a significant association between the FCGR3A-158V allele and RA and then sought to estimate specific subgroup effects.

Methods FCGR3A-158F/V genotyping was undertaken in a UK Caucasian replication cohort comprising 2049 patients with RA and 1156 controls. Subgroup analyses assessing the magnitude of association according to gender and autoantibody (rheumatoid factor (RF) and cyclic citrullinated peptide (CCP)) status were undertaken in a pooled cohort of 2963 patients with RA and 1731 controls. Logistic regression was used to test for interaction between FCGR3A and HLA-DRB1 shared epitope (SE) alleles.

Results In the combined RA cohort, borderline association with homozygosity was found for the FCGR3A-158V allele (OR 1.2, p=0.05), which was stronger in men (OR 1.7, p=0.01). Stratification by autoantibody status showed an increased risk in RF and CCP positive RA. Analysis of the FCGR3A-158V and HLA-DRB1 SE interaction revealed roles for both genes in susceptibility to autoantibody positive RA, with no evidence of interaction.

Conclusions FCGR3A is a risk factor for the development of autoantibody positive RA, particularly in men, with evidence of a multiplicative effect with HLA-DRB1 SE.

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  • Funding This work was supported by the Arthritis Research Campaign, UK and the NIHR-Leeds Musculoskeletal Biomedical Research Unit.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Northern and Yorkshire multicentre research ethics committee and all participants gave informed consent.

  • Provenance peer review Not commissioned; externally peer reviewed.

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