{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T08:22:28Z","timestamp":1767860548939,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,7,12]],"date-time":"2020-07-12T00:00:00Z","timestamp":1594512000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Anti\u2010citrullinated peptide antibody (ACPA) and rheumatoid factor (RF) define \u2018seropositive\u2019 rheumatoid arthritis (RA). Both predict unfavourable disease course, development of extra\u2010articular features and treatment outcomes. We investigated the prevalence of seroconversion to ACPA after commencement of triple disease\u2010modifying anti\u2010rheumatic drug (DMARD) treat\u2010to\u2010target therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To Investigate the prevalence of seroconversion to ACPA after commencement of triple DMARD treat\u2010to\u2010target therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>DMARD\u2010na\u00efve patients with RA according to the 1987 American College of Rheumatology criteria and disease duration of &lt;96\u2009weeks were enrolled. RF and ACPA levels were recorded at baseline and sequentially during triple DMARD therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 368 patients was followed for a median of 272\u2009weeks. Of 154 patients seronegative for ACPA at recruitment, 10 (6.5%) seroconverted at some point. Nine of these were positive for RF at baseline and baseline RF titre was predictive of seroconversion. Four (2.6%) patients remained seropositive. No patients seroconverted from negative to positive for both RF and ACPA. Median time to seroconversion for ACPA was 29 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Persistent seroconversion of ACPA from negative to positive after diagnosis in patients with RA is uncommon. ACPA and RF double negative patients are highly unlikely ever to develop ACPA positivity with a risk &lt;1%. It is therefore unlikely to be helpful or cost\u2010effective to perform serial ACPA measurements in patients with seronegative RA after commencement of a treat\u2010to\u2010target strategy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.14463","type":"journal-article","created":{"date-parts":[[2020,7,13]],"date-time":"2020-07-13T01:41:31Z","timestamp":1594604491000},"page":"818-822","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Repeat serological testing for anti\u2010citrullinated peptide antibody after commencement of therapy is not helpful in patients with seronegative rheumatoid arthritis"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2464-4620","authenticated-orcid":false,"given":"Alistair B.","family":"Reid","sequence":"first","affiliation":[{"name":"Department of Rheumatology The Royal Adelaide Hospital  Adelaide South Australia Australia"},{"name":"Department of 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