{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T20:43:06Z","timestamp":1793479386373,"version":"4.5.0"},"reference-count":45,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,5,28]],"date-time":"2018-05-28T00:00:00Z","timestamp":1527465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010663","name":"H2020 European Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006315","name":"Reumafonds","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006315","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Because of its association with joint destruction, anti\u2013citrullinated protein antibody (ACPA)\u2013positive rheumatoid arthritis (RA) is considered to be more severe than ACPA\u2010negative RA. Clinically relevant joint destruction is now infrequent thanks to adequate disease suppression. According to patients, important outcomes are pain, fatigue, and independence. We evaluated whether ACPA\u2010positive RA patients diagnosed during or after 2000 have more severe self\u2010reported limitations and impairments, including restrictions at work, than ACPA\u2010negative RA patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 492 ACPA\u2010positive and 450 ACPA\u2010negative RA patients who fulfilled the 2010 criteria and were included in the Leiden Early Arthritis Clinic cohort during or after 2000 were compared for self\u2010reported pain, fatigue, disease activity, general well\u2010being (measured by numerical rating scales), physical function (measured by the Health Assessment Questionnaire), and work restrictions, including absenteeism at baseline and during the 4\u2010year followup. Linear mixed models were used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At disease presentation, ACPA\u2010negative patients had more severe pain, fatigue, self\u2010reported disease activity scores, and functional disability (<jats:italic>P<\/jats:italic> &lt; 0.05), although absolute differences were small. During followup, ACPA\u2010negative patients remained somewhat more fatigued (<jats:italic>P<\/jats:italic> = 0.002), whereas other patient\u2010reported impairments and limitations were similar. Thirty\u2010eight percent of ACPA\u2010negative and 48% of ACPA\u2010positive patients reported absenteeism (<jats:italic>P<\/jats:italic> = 0.30), with median 4 days missed in both groups in the last 3 months. Also, restrictions at work among employed patients and restrictions with household work were not statistically different at baseline and during followup.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In current rheumatology practice, ACPA\u2010positive RA is not more severe than ACPA\u2010negative RA in terms of patients\u2019 relevant outcomes, including physical functioning and restrictions at work. This implies that efforts to further improve the disease course should be proportional to both disease subsets.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23497","type":"journal-article","created":{"date-parts":[[2017,12,20]],"date-time":"2017-12-20T23:26:20Z","timestamp":1513812380000},"page":"987-996","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Is Anti\u2013Citrullinated Protein Antibody\u2013Positive Rheumatoid Arthritis Still a More Severe Disease Than Anti\u2013Citrullinated Protein Antibody\u2013Negative Rheumatoid Arthritis? A Longitudinal Cohort Study in Rheumatoid Arthritis Patients Diagnosed From 2000 Onward"],"prefix":"10.1002","volume":"70","author":[{"given":"Aleid C.","family":"Boer","sequence":"first","affiliation":[{"name":"Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelies","family":"Boonen","sequence":"additional","affiliation":[{"name":"Care and Public Health Research Institute, and Maastricht University Medical Center Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette H. 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