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Rheumatoid arthritis

Are ACPA-positive and ACPA-negative RA the same disease?

Nature Reviews Rheumatology volume 7, pages 202–203 (2011)Cite this article

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Seemingly contrasting genetic backgrounds in anti-citrullinated-protein antibody (ACPA)-positive and ACPA-negative rheumatoid arthritis (RA) support the notion that these are in fact two distinct disease subsets, with different underlying pathogenesis, that might need tailored treatment strategies.

Disease outcomes in RA are highly variable between patients. We know that, to a certain extent, the presence or absence of ACPAs can predict these outcomes. Indeed, ACPAs are one of the best clinical predictors of radiological progression.1 Moreover, it has been shown that patients with ACPA-negative disease are more likely to achieve drug-free remission than those who test positive for these autoantibodies. Recently, Padyukov et al.2 published a study in which they investigated the genetic background of the two disease subsets, as characterized by ACPA status.

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Acknowledgements

The authors' work is supported by grants from the Dutch Arthritis Foundation and the European Union (Sixth Framework Program integrated project Autocure and Seventh Framework Program integrated project Masterswitch number 223404).

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  1. Department of Rheumatology, Leiden University Medical Center, Albinusdreef 2, 2333ZA, Leiden, The Netherlands

    Nina A. Daha & Rene E. M. Toes

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  1. Nina A. Daha
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  2. Rene E. M. Toes
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Correspondence to Nina A. Daha.

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Daha, N., Toes, R. Are ACPA-positive and ACPA-negative RA the same disease?. Nat Rev Rheumatol 7, 202–203 (2011). https://doi.org/10.1038/nrrheum.2011.28

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