Rheumatoid arthritis associated autoantibodies in patients with synovitis of recent onset

Raphaela Goldbach-Mansky, Jennifer Lee, Angela McCoy, Joseph Hoxworth, Cheryl Yarboro, Josef S. Smolen, Günter Steiner, Antony Rosen, Cindy Zhang, Henri A. Ménard, Zhi Jie Zhou, Timo Palosuo, Walther J. Van Venrooij, Ronald L. Wilder, John H. Klippel, H. Ralph Schumacher, Hani S. Ei-Gabalawy

Research output: Contribution to journalArticlepeer-review

317 Scopus citations


An inception cohort of 238 patients having peripheral joint synovitis of less than 12 months duration was evaluated clinically and followed prospectively for 1 year to determine the clinical significance of a number of rheumatoid arthritis (RA) associated autoantibodies. Serum samples collected at the time of the initial evaluation were tested for rheumatoid factor (RF) and antibodies to Sa (anti-Sa), RA-33, (pro)filaggrin [antifilaggrin antibody (AFA), cyclic citrullinated peptide (anti-CCP), calpastatin, and keratin [antikeratin antibody (AKA). RF had a sensitivity of 66% and a specificity of 87% for RA. Anti-Sa, AFA, and anti-CCP all had a specificity of more than 90%, but a sensitivity of less than 50% for this diagnosis. Overall, there was a high degree of correlation between AFA, AKA, anti-Sa or anti-CCP, this being highest between anti-Sa and anti-CCP (odds ratio, 13.3; P<0.001). Of the 101 patients who were positive for at least one of these four autoantibodies, 57% were positive for only one. Finally, anti-Sa identified a subset of predominantly male RA patients with severe, erosive disease. Anti-Sa, AFA and anti-CCP are all specific for early RA but, overall, have little additional diagnostic value over RF alone. Although these antibodies may preferentially recognize citrullinated antigens, the modest degree of concordance between them in individual patient sera suggests that it is unlikely a single antigen is involved in generating these responses.

Original languageEnglish (US)
Pages (from-to)236-243
Number of pages8
JournalArthritis Research
Issue number3
StatePublished - 2000


  • Autoantibodies
  • Early synovitis
  • Human leukocyte antigen
  • Rheumatoid arthritis
  • Spondylarthropathy

ASJC Scopus subject areas

  • Rheumatology


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