Rheumatology

The Role of Rheumatoid Factor
in Rheumatoid Arthritis

 

Discover more about the role of rheumatoid factor in rheumatoid arthritis

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What is Rheumatoid Factor?

The Role of Rheumatoid Factor in Rheumatoid Arthritis

Personalising approaches to rheumatoid arthritis treatment. What role could rheumatoid factor play?

1937

 

Rheumatoid factor first discovered in a patient with rheumatoid arthritis1

 
 

1956

 

Included in the ARA diagnostic criteria for definite rheumatoid arthritis as “positive sheep cell agglutination”2

1958

 

Characterisation of antibodies and gamma globulin that interact with rheumatoid factor3

 
 

1962

 

Rheumatoid factor identified as a poor prognostic factor in rheumatoid arthritis4

1969

 

Rheumatoid factor binding to Ig causes complement activation5

 
 

1987

 

Included in the 1987 ACR revised classification criteria for rheumatoid arthritis6

2013

 

Rheumatoid factor has limited clinical usefulness in monitoring disease activity and treatment response7

 
 

PRESENT

 

Rheumatoid factor is widely recognised as a diagnostic and prognostic marker for rheumatoid arthritis and is used to inform better disease management7,8

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High rheumatoid factor levels

(above 200 IU/ml) are associated with higher probability of radiographic progression9

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What do we know about the role
of rheumatoid factor in rheumatoid arthritis?

Impact on treatment responses

 

The presence of rheumatoid factor has a clear association with higher levels of disease activity,13 especially when detected at high levels.9,14–20 

 

Therefore, patients with rheumatoid arthritis and high rheumatoid factor experience a more severe and aggressive disease course which requires intensive treatment to improve outcomes.20

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Patients with rheumatoid arthritis and high rheumatoid factor may require a personalised approach to the management of their disease

Higher levels of disease activity

 

Many biologic disease-modifying anti-rheumatic drugs used for the treatment of rheumatoid arthritis contain fragment crystallisable (Fc) regions.10 This means that rheumatoid factor can also target the Fc region of these drugs to form immune complexes.11,12

 

These immune complexes could be impacting treatment response in patients with rheumatoid arthritis and high rheumatoid factor levels.12

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Explore how the structure of rheumatoid factor links to its mechanism of action

 

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Abbreviations

EU: European Union; ACR: American College of Rheumatology; ARA: American Rheumatism Association; Fc: fragment crystallisable; Ig: immunoglobulin; SpA: spondyloarthritis; US: United States.

References

  1. Waaler E. APMIS. 2007;115(5):422–38;
  2. Ropes MW, et al. Ann Rheum Dis. 1957;16(1):118–25; 
  3. Edelman GM, et al. J Exp Med. 1958;108(1):105–20; 
  4. Ragan C, Farrington E. JAMA. 1962;181(8):663–7; 
  5. Zvaifler NJ. J Clin Invest. 1969;48(8):1532–1542; 
  6. Arnett FC, et al. Arthritis Rheum. 1988;31(3):315–24; 
  7. Ingegnoli F, et al. Dis Markers. 2013;35(6):727–34; 
  8. de Brito Rocha S, et al. Adv Rheumatol. 2019;59(1):2;
  9. Vastesaeger N, et al. Rheumatology (Oxford). 2009;48(9):1114–21; 
  10. Senolt L. F1000Res. 2019;8:F1000 Faculty Rev-1549; 
  11. Maibom-Thomsen SL, et al. PLoS One. 2019;14(6):e0217624; 
  12. Levy RA, et al. Immunotherapy. 2016;8(12):1427–36; 
  13. Aletaha D, et al. Arthritis Res Ther. 2015;17(1):229; 
  14. Albrecht K, et al. Arthritis Res Ther. 2017;19(1):68; 
  15. Sobhy N, et al. Egypt Rheumatol. 2022;44(4):325–8; 
  16. van Zeben D, et al. Ann Rheum Dis. 1992;51(9):1029–35;
  17. Cojocaru M, et al. Maedica (Bucur). 2010;5(4):286–91; 
  18. Nell VPK, et al. Ann Rheum Dis. 2005;64(12):1731–6; 
  19. England BR, et al. Arthritis Care Res (Hoboken). 2016;68(1):36–45; 
  20. Katchamart W, et al. Rheumatol Int. 2015;35(10):1693–9.

EU-DA-2300317

 

Date of preparation: August 2024