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Elevated rheumatoid factor and long term risk of rheumatoid arthritis: a prospective cohort study

Sune F Nielsen1, Stig E Bojesen, Peter Schnohr

  • 1Department of Clinical Biochemistry, 54M1, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark.

BMJ (Clinical Research Ed.)
|September 8, 2012
PubMed

Insights

Elevated rheumatoid factor (RF) levels significantly increase the long-term risk of developing rheumatoid arthritis. Testing for RF may aid in early detection and referral for rheumatoid arthritis.

Area of Science:

  • Rheumatology
  • Immunology
  • Epidemiology

Background:

  • Rheumatoid factor (RF) is an autoantibody often found in patients with rheumatoid arthritis.
  • The predictive value of elevated RF levels for the long-term development of rheumatoid arthritis in the general population requires further investigation.

Purpose of the Study:

  • To determine if elevated plasma IgM rheumatoid factor (RF) concentrations are associated with the long-term development of rheumatoid arthritis (RA).

Main Methods:

  • A prospective cohort study involving 9712 white Danish individuals from the general population was conducted.
  • Participants were followed for up to 29 years, with baseline plasma RF levels categorized.
  • Rheumatoid arthritis development was assessed based on baseline RF levels.

Main Results:

  • A doubling in RF levels was associated with a 3.3-fold increased risk of developing RA.
  • The cumulative incidence of RA increased significantly with higher RF categories (P<0.0001).
  • Individuals with RF levels >100 IU/mL had a 26-fold increased risk of RA, with a 32% 10-year absolute risk in specific subgroups.

Conclusions:

  • Elevated RF levels in the general population are strongly associated with a significantly increased long-term risk of developing RA.
  • These findings suggest that RF testing could be a valuable tool for identifying individuals at high risk for RA.
  • The results may inform revised guidelines for early rheumatologist referral and the establishment of early arthritis clinics.
Abstract

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