almost significantP = 0.051
We obtained an association for Val 11 with SJC that was almost significant (β coefficient of 0.25 [95% CI −0.00, 0.50], P = 0.051), but there was no significant association of ACPA status with SJC (β coefficient of 0.22 [95% CI −0.15, 0.59], P = 0.24), indicating that it is not possible to determine whether the nonsystemic effect of Val 11 is direct or mediated by ACPA status (green arrows in Figure 2 B).