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Identification of Lifelines participants at high risk for development of rheumatoid arthritis
  1. S Arends1,
  2. L A Trouw,
  3. R E M Toes2,
  4. A van Zanten2,1,
  5. C Roozendaal3,
  6. P C Limburg,
  7. H Bootsma3,1,
  8. E Brouwer1
  1. 1Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  2. 2Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  3. 3Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  1. Correspondence to Dr E Brouwer, Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen 9713GZ, The Netherlands; e.brouwer{at}umcg.nl

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We would like to thank Michael Mahler1 for his letter, ‘Population-based screening for anticitrullinated protein antibodies (ACPA): A step in the pathway to the prevention of rheumatoid arthritis?’ In his letter, Dr Mahler makes a plea to analyse and define reliable biomarkers to identify subjects who are on the trajectory to develop rheumatoid arthritis (RA). We agree with this notion of Dr Mahler as current efforts are increasingly focusing on the possibility to install early preclinical treatment to prevent progression to RA. For example, several randomised placebo-controlled trials (RCTs) have been initiated recently. These clinical trials will investigate the therapeutic potential of several immunomodulatory agents such as rituximab (PRAIRI study: NTR No. 1969), abatacept (APIPPRA study: ISRCTN No. 46017566 and ARIAA study: EudraCT …

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