Autoantibodies as predictors of progression to rheumatoid arthritis : a systematic review and meta-analysis
(2026) In RMD Open 12(1).- Abstract
Background The aim of this systematic review and meta-analysis was to examine autoantibody positive individuals and define: (a) the relative risk of rheumatoid arthritis (RA) compared with autoantibody negative individuals and (b) the cumulative incidence of RA over time, in different populations. Methods A systematic literature search was performed in August 2025. Retrospective case control studies of individuals with RA and healthy matched controls were identified and relative risk of RA was calculated. Prospective observational studies or randomised controlled trials of autoantibody positive individuals were identified and pooled survival models were used to estimate cumulative incidence of progression to arthritis. Results 293... (More)
Background The aim of this systematic review and meta-analysis was to examine autoantibody positive individuals and define: (a) the relative risk of rheumatoid arthritis (RA) compared with autoantibody negative individuals and (b) the cumulative incidence of RA over time, in different populations. Methods A systematic literature search was performed in August 2025. Retrospective case control studies of individuals with RA and healthy matched controls were identified and relative risk of RA was calculated. Prospective observational studies or randomised controlled trials of autoantibody positive individuals were identified and pooled survival models were used to estimate cumulative incidence of progression to arthritis. Results 293 full-text articles fulfilled screening criteria and 26 were eligible for meta-analysis. The presence of serum autoantibodies confers between a 3.1 - 19.3-fold increase risk of developing RA. Prospective studies of anticyclic citrullinated peptide 2 (CCP2) or CCP3 positive individuals were grouped according to additional criteria; presence of arthralgia, presence/absence of immunoglobulin M rheumatoid factor (IgM-RF) and first-degree or second-degree relatives with RA. The estimated cumulative incidence of RA at 12 months was highest for CCP2 positive individuals with arthralgia and IgM-RF, at 35.2% (95% CI 29.3% to 41.2%). Conclusion A considerable number of autoantibodies have been examined as predictors for RA; however, the fastest rate of progression to RA in this study occurred in those with CCP2 and IgM-RF in combination with arthralgia. Importantly, the risk of developing RA changes over time for individuals with arthralgia, and they are at the highest risk of progression within the first 24 months of follow-up.
(Less)
- author
- organization
- publishing date
- 2026-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Anti-Citrullinated Protein Antibodies, Arthritis, Rheumatoid, Epidemiology, Rheumatoid Factor
- in
- RMD Open
- volume
- 12
- issue
- 1
- article number
- e006368
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:41672721
- scopus:105029988476
- ISSN
- 2056-5933
- DOI
- 10.1136/rmdopen-2025-006368
- language
- English
- LU publication?
- yes
- id
- 1d1f8db9-5f43-49e4-8326-fb212c928091
- date added to LUP
- 2026-04-17 12:03:02
- date last changed
- 2026-05-15 15:38:45
@article{1d1f8db9-5f43-49e4-8326-fb212c928091,
abstract = {{<p>Background The aim of this systematic review and meta-analysis was to examine autoantibody positive individuals and define: (a) the relative risk of rheumatoid arthritis (RA) compared with autoantibody negative individuals and (b) the cumulative incidence of RA over time, in different populations. Methods A systematic literature search was performed in August 2025. Retrospective case control studies of individuals with RA and healthy matched controls were identified and relative risk of RA was calculated. Prospective observational studies or randomised controlled trials of autoantibody positive individuals were identified and pooled survival models were used to estimate cumulative incidence of progression to arthritis. Results 293 full-text articles fulfilled screening criteria and 26 were eligible for meta-analysis. The presence of serum autoantibodies confers between a 3.1 - 19.3-fold increase risk of developing RA. Prospective studies of anticyclic citrullinated peptide 2 (CCP2) or CCP3 positive individuals were grouped according to additional criteria; presence of arthralgia, presence/absence of immunoglobulin M rheumatoid factor (IgM-RF) and first-degree or second-degree relatives with RA. The estimated cumulative incidence of RA at 12 months was highest for CCP2 positive individuals with arthralgia and IgM-RF, at 35.2% (95% CI 29.3% to 41.2%). Conclusion A considerable number of autoantibodies have been examined as predictors for RA; however, the fastest rate of progression to RA in this study occurred in those with CCP2 and IgM-RF in combination with arthralgia. Importantly, the risk of developing RA changes over time for individuals with arthralgia, and they are at the highest risk of progression within the first 24 months of follow-up.</p>}},
author = {{Qureshi, Sumera and Adas, Maryam and Cope, Phoebe J. and Mahfouz, Hassan and Bechman, Katie and Deane, Kevin D. and El-Gabalawy, Hani and Emery, Paul and Finckh, Axel and Gilbert, Benoît Thomas P. and Holers, V. Michael and Isaacs, John D. and Kastbom, Alf and Mankia, Kulveer and Mikuls, Ted R. and Pratt, Arthur G. and Rech, Juergen and Russell, Mark D. and Schett, Georg and Trouw, Leendert A. and Turesson, Carl and Beers-Tas, Marian H.van and Van Der Helm-Van Mil, Annette H.M. and Van Schaardenburg, Dirkjan and Van Steenbergen, Hanna W. and Toes, René E.M. and Cope, Andrew P. and Galloway, James and Norton, Sam}},
issn = {{2056-5933}},
keywords = {{Anti-Citrullinated Protein Antibodies; Arthritis, Rheumatoid; Epidemiology; Rheumatoid Factor}},
language = {{eng}},
number = {{1}},
publisher = {{BMJ Publishing Group}},
series = {{RMD Open}},
title = {{Autoantibodies as predictors of progression to rheumatoid arthritis : a systematic review and meta-analysis}},
url = {{http://dx.doi.org/10.1136/rmdopen-2025-006368}},
doi = {{10.1136/rmdopen-2025-006368}},
volume = {{12}},
year = {{2026}},
}