Article Text

other Versions

Download PDFPDF
Concise report
Patients with seronegative RA have more inflammatory activity compared with patients with seropositive RA in an inception cohort of DMARD-naïve patients classified according to the 2010 ACR/EULAR criteria
  1. Lena Bugge Nordberg1,
  2. Siri Lillegraven1,
  3. Elisabeth Lie1,
  4. Anna-Birgitte Aga1,
  5. Inge Christoffer Olsen1,
  6. Hilde Berner Hammer1,
  7. Till Uhlig1,
  8. Maria Karolina Jonsson1,2,
  9. Désirée van der Heijde1,3,
  10. Tore K Kvien1,
  11. Espen Andre Haavardsholm1
  12. and the ARCTIC working group
    1. 1Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
    2. 2Department of Rheumatology, Haukeland University Hospital, Bergen, Norway
    3. 3Leiden University Medical Center, Leiden, Netherlands
    1. Correspondence to Dr Lena Bugge Nordberg, Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen, Oslo N-0319, Norway; lenabuggenordberg{at}


    Objectives To compare the presentation of seropositive and seronegative early rheumatoid arthritis (RA) in disease-modifying antirheumatic drug (DMARD)-naïve patients classified according to the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) criteria.

    Methods All patients had symptom duration from first swollen joint <2 years and were DMARD naïve with an indication for DMARD treatment. Patients were stratified as seropositive (positive rheumatoid factor (RF)+ and/or anticitrullinated peptide antibody (ACPA)+) or seronegative (RF− and ACPA−), and disease characteristics were compared between groups.

    Results A total of 234 patients were included, and 36 (15.4%) were seronegative. Ultrasonography (US) scores for joints (median 55 vs 25, p<0.001) and tendons (median 3 vs 0, p<0.001), number of swollen joints (median 17 vs 8, p<0.001), disease activity score (DAS; mean 3.9 vs 3.4, p=0.03) and physician global assessment (mean 49.1 vs 38.9, p=0.006) were significantly higher in seronegative patients compared with seropositive. Total van der Heijde-modified Sharp score, Richie Articular Index and patient-reported outcome measures were similar between groups.

    Conclusions Seronegative patients had higher levels of inflammation, assessed both clinically and by US, than seropositive patients. These differences may reflect the high number of involved joints required for seronegative patients to fulfil the 2010 ACR/EULAR classification criteria for RA.

    Trial registration number NCT01205854; Pre-results.

    • Rheumatoid Arthritis
    • Ant-CCP
    • Rheumatoid Factor
    • Early Rheumatoid Arthritis

    Statistics from

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Linked Articles