{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:04:21Z","timestamp":1785769461558,"version":"3.56.0"},"reference-count":47,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2015,4,12]]},"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Anticyclic citrullinated protein antibodies (ACPA) are highly specific of rheumatoid arthritis (RA). However, they have also been detected in 5\u201310% of primary Sj\u00f6gren's syndrome (pSS). We compared ACPA-positive and negative patients with pSS and assessed the risk of evolution to RA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and methods<\/jats:title>\n                  <jats:p>ACPA-positive and negative patients with pSS were included in this study. For ACPA-positive patients, clinical and radiological re-evaluation was systematically performed after at least 5\u2005years of follow-up. Diagnosis was reassessed at the end of the follow-up to identify patients that developed RA according to the American College of Rheumatology 1987 classification criteria.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At inclusion in the cohort 16 patients with pSS were ACPA positive and 278 were ACPA negative. ACPA-positive patients, had more frequently arthritis (43.7% vs 12.2%; p=0.003) but not arthralgias. They also had more frequent lung involvement (25% vs 8.1%; p=0.05). After median follow-up of 8 (5\u201310) years, 7\/16 (43.8%) patients developed RA including 5 (31.25%) with typical RA erosions. Elevation of acute phase reactants at inclusion was the only parameter associated with progression to erosive RA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Median term follow-up of ACPA-positive patients with pSS showed that almost half of them developed RA, particularly in the presence of elevation of acute phase reactants. These results support the usefulness of a close radiological monitoring of these patients for early detection of erosive change not to delay initiation of effective treatment. Indeed, number of these patients with ACPA-positive pSS may actually have RA and associated SS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2015-000066","type":"journal-article","created":{"date-parts":[[2015,5,1]],"date-time":"2015-05-01T20:12:22Z","timestamp":1430511142000},"page":"e000066","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":50,"title":["ACPA-positive primary Sj\u00f6gren's syndrome: true primary or rheumatoid arthritis-associated Sj\u00f6gren's syndrome?"],"prefix":"10.1136","volume":"1","author":[{"given":"J","family":"Payet","sequence":"first","affiliation":[{"name":"Department of Rheumatology, H\u00f4pitaux Universitaires Paris-Sud, Assistance Publique\u2013Hopitaux de Paris (AP-HP), Universit\u00e9 Paris-Sud, INSERM U1184, Le Kremlin Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Belkhir","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, H\u00f4pitaux Universitaires Paris-Sud, Assistance Publique\u2013Hopitaux de Paris (AP-HP), Universit\u00e9 Paris-Sud, INSERM U1184, Le Kremlin Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J E","family":"Gottenberg","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Centre National de R\u00e9f\u00e9rence des Maladies Auto-Immunes Rares, INSERM UMRS_1109, F\u00e9d\u00e9ration de M\u00e9decine Translationnelle de Strasbourg (FMTS), Strasbourg University Hospital, Universit\u00e9 de Strasbourg, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Berg\u00e9","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, H\u00f4pitaux Universitaires Paris-Sud, Assistance Publique\u2013Hopitaux de Paris (AP-HP), Universit\u00e9 Paris-Sud, INSERM U1184, Le Kremlin Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Desmoulins","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, H\u00f4pitaux Universitaires Paris-Sud, Assistance Publique\u2013Hopitaux de Paris (AP-HP), Universit\u00e9 Paris-Sud, INSERM U1184, Le Kremlin Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Assistance Publique\u2013Hopitaux de Paris, Bichat Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X","family":"Mariette","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, H\u00f4pitaux Universitaires Paris-Sud, Assistance Publique\u2013Hopitaux de Paris (AP-HP), Universit\u00e9 Paris-Sud, INSERM U1184, Le Kremlin Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Seror","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, H\u00f4pitaux Universitaires Paris-Sud, Assistance Publique\u2013Hopitaux de Paris (AP-HP), Universit\u00e9 Paris-Sud, INSERM U1184, Le Kremlin Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,4,30]]},"reference":[{"key":"2025090313152794000_1.1.e000066.1","first-page":"168","article-title":"Systemic signs of primary Gougerot-Sj\u00f6gren syndrome. 48 cases","volume":"145","author":"Vidal","year":"1994","journal-title":"Ann Med Interne (Paris)"},{"key":"2025090313152794000_1.1.e000066.2","first-page":"995","article-title":"Systemic manifestations of primary Gougerot-Sj\u00f6gren syndrome. 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