Polyautoimmunity in RA, Regardless of ACPA Positivity Save
While it is believed that autoimmunity follows autoantibody positivity, a Danish study shows the incidence of polyautoimmunity to be similar in rheumatoid arthritis (RA) patients who are either anticyclic citrullinated peptide antibody (ACPA)–positive or ACPA–negative.
Data was drawn from RA adults in the DANBIO rheumatology register. Polyautoimmunity included 21 nonrheumatic autoimmune diseases.
A total of 5839 anti-CCP–positive and 3799 anti-CCP–negative RA patients were assessed for other autoimmune disorders. Polyautoimmune diseases were found in 11.1% and 11.9% in anti-CCP–positive and anti-CCP–negative patients, respectively (PR 0.93, 95% CI 0.84-1.05).
Most frequently associated autoimmune diseases were autoimmune thyroid disease, inflammatory bowel disease, and type 1 diabetes mellitus. After a mean follow-up of 3.5 years, only a few (n = 210) patients developed polyautoimmunity (HR 0.6, 95% CI 0.46-0.79).
Polyautoimmunity was found in ~10% of RA patients at time of diagnosis regardless of anti-CCP status. In the years subsequent to the RA diagnosis, only a few and mainly anti-CCP–negative patients developed autoimmune disease.
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