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Rheumatoid arthritis (RA) is characterised by frequent occurrence of autoantibodies. The anti-cyclic citrullinated peptide antibodies (anti-CCP) are now used routinely as they may antedate the development of seropositive RA, because their diagnostic sensitivity and specificity is better than rheumatoid factors (RFs), and because they may predict a more severe outcome.1,–,3 Previous studies have observed an increased prevalence of RF and anti-CCP in first-degree relatives of patients with RA.4 One study on RA discordant twin pairs provided evidence for genetic effects on IgM-RF and IgG-RF independent of HLA-DR.5 Anti-CCPs have been reported to be independently associated with the HLA-DRB1 shared epitope, PTPN22 and smoking, …
Funding Danish Rheumatism Association, Danish Medical Association's Research Foundation, Karen Hansens Foundation.
Competing interests None.
Patient consent Obtained.
Ethics approval This study was conducted with the approval of the regional ethics committee of Southern Denmark.
Provenance and peer review Not commissioned; externally peer reviewed.