PT  - JOURNAL ARTICLE
AU  - D S Majka
AU  - K D Deane
AU  - L A Parrish
AU  - A A Lazar
AU  - A E Barón
AU  - C W Walker
AU  - M V Rubertone
AU  - W R Gilliland
AU  - J M Norris
AU  - V M Holers
TI  - Duration of preclinical rheumatoid arthritis-related autoantibody positivity increases in subjects with older age at time of disease diagnosis
AID  - 10.1136/ard.2007.076679
DP  - 2008 Jun 01
TA  - Annals of the Rheumatic Diseases
PG  - 801--807
VI  - 67
IP  - 6
4099  - http://ard.bmj.com/content/67/6/801.short
4100  - http://ard.bmj.com/content/67/6/801.full
SO  - Ann Rheum Dis2008 Jun 01; 67
AB  - Objectives: To investigate factors that may influence the prevalence and timing of appearance of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies during the preclinical phase of rheumatoid arthritis (RA) development.Methods: 243 serial prediagnosis serum samples from 83 subjects with RA were examined for the presence of RF and anti-CCP antibodies.Results: Of the 83 cases, 47 (57%) and 51 (61%) subjects had at least one prediagnosis sample positive for RF or anti-CCP, respectively. Gender and race were not significantly associated with the prevalence or timing of preclinical antibody appearance. Preclinical anti-CCP positivity was strongly associated with the development of erosive RA (odds ratio = 4.64; 95% confidence interval 1.71 to 12.63; p<0.01), but RF was not (p = 0.60). Additionally, as age at the time of diagnosis of RA increased the duration of prediagnosis antibody positivity for RF and anti-CCP increased, with the longest duration of preclinical antibody positivity seen in patients diagnosed with RA over the age of 40. In no subjects did symptom onset precede the appearance of RF or anti-CCP antibodies.Conclusions: The period of time that RF and anti-CCP are present before diagnosis lengthens as the age at the time of diagnosis of RA increases. This finding suggests that factors such as genetic risk or environmental exposure influencing the temporal relationship between the development of RA-related autoantibodies and clinically apparent disease onset may differ with age.