{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T13:52:44Z","timestamp":1793713964672,"version":"4.6.1"},"reference-count":51,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T00:00:00Z","timestamp":1671408000000},"content-version":"unspecified","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"China Research Council","award":["No. 201708330243"],"award-info":[{"award-number":["No. 201708330243"]}]},{"name":"European Research Council","award":["no. 724517"],"award-info":[{"award-number":["no. 724517"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2022,8,22]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Predicting progression to clinical arthritis in individuals at-risk of developing rheumatoid arthritis is a prerequisite to developing stratification groups for prevention strategies. Selecting accurate predictive criteria is the critical step to define the population at-risk. While positivity for anti-citrullinated protein antibodies (ACPA) remains the main recruitment biomarker, positivity for other autoantibodies (AutoAbs) identified before the onset of symptoms, may provide additional predictive accuracy for stratification.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To perform a multiple AutoAbs analysis for both the prediction and the time of progression to inflammatory arthritis (IA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>392 individuals were recruited based on a new musculoskeletal complaint and positivity for ACPA or rheumatoid factor (RF). ELISAs were performed for ACPA, RF, anti-nuclear Ab, anti-carbamylated protein (anti-CarP) and anti-collagen AutoAbs. Logistic and COX regression were used for analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Progression to IA was observed in 125\/392 (32%) of cases, of which 78 progressed within 12 months. The AutoAbs ACPA, RF, anti-CarP were individually associated with progression (p&lt;0.0001) and improved prediction when combined with demographic\/clinical data (Accuracy &gt;77%; area under the curve (AUC) &gt;0.789), compared with prediction using only demographic\/clinical data (72.9%, AUC=0.760). Multiple AutoAbs testing provided added value, with +6.4% accuracy for number of positive AutoAbs (AUC=0.852); +5.4% accuracy for AutoAbs levels (ACPA\/anti-CarP, AUC=0.832); and +6.2% accuracy for risk-groups based on high\/low levels (ACPA\/RF\/anti-CarP, AUC=0.837). Time to imminent progression was best predicted using ACPA\/anti-CarP levels (AUC=0.779), while the number of positive AutoAbs was\/status\/risk were as good (AUC=0.778).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>We confirm added value of multiple AutoAbs testing for identifying progressors to clinical disease, allowing more specific stratification for intervention studies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2022-002512","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T11:18:15Z","timestamp":1671448695000},"page":"e002512","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Added value of multiple autoantibody testing for predicting progression to inflammatory arthritis in at-risk individuals"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3969-7701","authenticated-orcid":false,"given":"Frederique","family":"Ponchel","sequence":"first","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7631-0986","authenticated-orcid":false,"given":"Laurence","family":"Duquenne","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuanxiao","family":"Xie","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Corscadden","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farag","family":"Shuweihdi","sequence":"additional","affiliation":[{"name":"Leeds Institute of Health Sciences, Faculty of Medicine, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7945-6582","authenticated-orcid":false,"given":"K","family":"Mankia","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L A","family":"Trouw","sequence":"additional","affiliation":[{"name":"Department of Immunology, Leiden University Medical Center, Leiden, 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