{"doi":"10.1002/acr2.11704","title":"Multi‐Autoantibody Testing Identifies Expansion of Reactivity to Targeted Antigens Before a Diagnosis of Rheumatoid Arthritis","abstract":"OBJECTIVE: Rheumatoid arthritis (RA) has a \"pre-RA\" period in which multiple autoantibodies, including antibodies to citrullinated (cit) proteins (ACPA), rheumatoid factor (RF), anti-peptidyl arginine deiminase (anti-PAD), among others, have been described; however, few studies have tested all autoantibodies in a single pre-RA cohort. This study aims to evaluate the prevalence of multiple autoantibodies in pre-RA and potentially identify an autoantibody profile in pre-RA that indicates imminent onset of clinical RA. METHODS: We evaluated 148 individuals with two pre- and one post-RA diagnosis samples available from the Department of Defense Serum Repository and matched controls. Samples were tested for immuglobulin (Ig) G anti-cyclic cit peptide-3 (anti-CCP3), five ACPA fine specificities, five anti-PAD isoforms, as well as RF IgA and RF IgM using commercial platforms; cutoffs were determined using levels present in <1% of controls. RESULTS: Positivity of anti-CCP3, RF IgA and RF IgM, anti-PAD1, anti-cit-vimentin 2, anti-cit-fibrinogen, and anti-cit-histone 1 increased over time in pre-RA, although anti-PAD and ACPA fine specificities were predominately present within anti-CCP3-positive individuals. Within anti-CCP3-positive samples from the pre-RA period, positivity for RFs as well as anti-PAD and ACPA fine specificities classified samples as being closer to the time of RA diagnosis. CONCLUSION: Multiple autoantibodies are present in pre-RA and increase in positivity as the time of RA diagnosis approaches. These results confirm previous findings predicting imminent RA and provide a pathway using commercial-grade assays to assess the risk for and timing of development of clinical RA.","journal":"ACR Open Rheumatology","year":2024,"id":452246,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9626,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":725160,"name":"Dylan T. Bergstedt","orcid":null,"position":1,"is_corresponding":false},{"id":335239,"name":"Marie L. Feser","orcid":"0009-0003-0598-853X","position":2,"is_corresponding":false},{"id":335968,"name":"LauraKay Moss","orcid":null,"position":3,"is_corresponding":false},{"id":314417,"name":"Ted R. Mikuls","orcid":"0000-0002-0897-2272","position":4,"is_corresponding":false},{"id":335241,"name":"Jess D. Edison","orcid":"0000-0002-5260-0273","position":5,"is_corresponding":false},{"id":41942,"name":"V. Michael Holers","orcid":"0000-0002-5634-7746","position":6,"is_corresponding":false},{"id":1274048,"name":"Laura Martínez-Prat","orcid":"0000-0003-3812-9590","position":7,"is_corresponding":false},{"id":1274049,"name":"Mary Ann Aure","orcid":"0000-0002-1971-0411","position":8,"is_corresponding":false},{"id":251393,"name":"Michael Mähler","orcid":"0000-0002-7919-0948","position":9,"is_corresponding":false},{"id":305659,"name":"Kevin D. Deane","orcid":"0000-0003-2211-4861","position":10,"is_corresponding":false},{"id":1141519,"name":"Salina H. Goff","orcid":"0000-0003-1189-6976","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-19T02:02:50.407779Z","pmid":"38950890","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}