A core set of risk factors in individuals at risk of rheumatoid arthritis: a systematic literature review informing the EULAR points to consider for conducting clinical trials and observational studies in individuals at risk of rheumatoid arthritis.

8 Prior to the availability of ACPA testing, a large longitudinal study of >2000 INAs monitored bi-annually for 19 years revealed a highly significant association between RF level and RA development (p<0.01, controlling for age and sex). 9 In a recent study of anti-CCP3-positive individuals identified by population screening at health fairs in the USA, 35 of 250 individuals who tested anti-CCP3 positive were recruited and followed longitudinally for mean of 2.56 years. 10 Forty per cent of these subjects developed IA. 10 In at-risk individuals with MSK symptoms (seropositive arthralgia, clinically suspect arthralgia, ACPA positive with MSK symptoms), ACPA levels are also strongly associated with progression to IA.

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