A core set of risk factors in individuals at risk of rheumatoid arthritis: a systematic literature review informing the EULAR points to consider for conducting clinical trials and observational studies in individuals at risk of rheumatoid arthritis.

Abstract

BACKGROUND:

There is significant interest in determining risk factors in individuals at risk of rheumatoid arthritis (RA). A core set of risk factors for clinical arthritis development has not been defined.

METHODS:

A literature search and systematic literature review (SLR) was conducted to identify risk factors in individuals at risk of RA using Medline, Embase, PubMed and Central databases.

RESULTS:

3854 articles were identified by the literature search. After screening of titles, 138 abstracts were reviewed and 96 articles finally included. Fifty-three articles included data on risk factors including autoantibodies, subclinical inflammation on imaging, clinical features, serum and cellular biomarkers and genetic markers. Risk factors were dependent on the at-risk population. There was good evidence for serum anticitrullinated protein antibodies (ACPA) levels, as risk factors for arthritis in all at-risk populations (n=13 articles). Subclinical inflammation on ultrasound (n=12) and MRI (n=6) was reported as a risk factor in multiple studies in at-risk individuals with musculoskeletal (MSK) symptoms and undifferentiated arthritis (UA). Clinical features were reported as a risk factor in at-risk individuals with MSK symptoms and UA (n=13). Other risk factors, including serum and cellular markers were less frequently reported.

CONCLUSIONS:

Risk factors for arthritis development in RA are specific to the at-risk population. Serum ACPA confers risk in all populations; subclinical inflammation on imaging and clinical features confer risk in at-risk individuals with MSK symptoms. This SLR informed the EULAR taskforce for points to consider on conducting clinical trials and studies in individuals at risk of RA.

• Authors: Kulveer Mankia, Heidi Siddle, Andrea Di Matteo, Deshiré Alpízar-Rodríguez, Joel Kerry, Andreas Kerschbaumer, Daniel Aletaha, Paul Emery
• Journal: RMD open (RMD Open) Vol. 7 Issue 3 (09 2021) ISSN: 2056-5933 [Electronic] England
• PMID: 34531306 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Systematic Review)
• Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Autoantibodies
• Biomarkers

Topics

• Arthritis, Rheumatoid
• Autoantibodies
• Biomarkers
• Clinical Trials as Topic
• Humans
• Observational Studies as Topic
• Risk Factors
• Ultrasonography