Impact of Dual Rheumatoid Factor and Anticitrullinated Protein Antibody Seropositive, Single Seropositive, and Seronegative Rheumatoid Arthritis on Outcomes
Authors' conclusion
Patients with RA seropositive for RF only have an increase in mortality rates compared with patients who are dual seronegative.
Study context
- Population
- Residents of Southern Minnesota with incident rheumatoid arthritis (RA) fulfilling criteria in 2003 to 2019
- Participants
- 1,373 residents
- Exposure
- Dual seropositive, rheumatoid factor (RF)-only and anti-cyclic citrullinated protein (anti-CCP)-only seropositive RA vs seronegative RA
- Outcome
- Radiographic erosions, disease flares and all-cause mortality
Methodological detailspopulation-based, Cox models adjusted for age, sex, smoking status, year of incident RA and comorbidities
- Population-based
- Cox models adjusted for age, sex, smoking status, year of incident RA and comorbidities
Main finding
As reported in the abstract
All-cause mortality
Each group vs seronegativeAdjusted hazard ratio (95% CI)
RF only
2.18(1.47–3.24)
Dual seropositive
1.66(1.21–2.28)
Anti-CCP only
1.32(0.83–2.11)
Observational data: associations, not effects.
Further findings
Serostatus distribution at RA incidence
| Outcome | Dual seropositive | Anti-CCP only | RF only | Seronegative |
|---|---|---|---|---|
| Radiographic erosions before or within 1 year of RA incidence · within one year of RA incidenceHighest in dual seropositive, lowest in anti-CCP only | 31% | 13% | — not stated in the abstract | — not stated in the abstract |
| Flares within first year of RA incidence | 69% | 51% | — not stated in the abstract | — not stated in the abstract |
— not stated in the abstract
Original publication
Impact of Dual Rheumatoid Factor and Anticitrullinated Protein Antibody Seropositive, Single Seropositive, and Seronegative Rheumatoid Arthritis on Outcomes. Arthritis Care Res (Hoboken). Published 18 February 2026. doi:10.
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