Autoimmune markers for the diagnosis of rheumatoid arthritis in primary care: primary care diagnostic technology update

British Journal of General Practice, October 2013 553 BACkground And AdvAntAges over exIstIng teChnology Early diagnosis and treatment of rheumatoid arthritis (RA) is important in preventing long-term damage and disability. RA should be suspected largely on the basis of clinical findings, such as persistent joint pain, swelling, and stiffness. Further investigations, particularly in primary care, may contribute to the diagnosis. Rheumatoid factor (RF) is an autoantibody associated with RA and its presence has traditionally been used to support the diagnosis. However, RF has a low specificity in primary care and cannot be used to rule in or rule out disease. In contrast, anti-citrullinated peptide antibody (ACPA) has emerged as an alternative serological test, as it has greater specificity and may be preferable to RF in the diagnosis of RA.1 However, it is not yet generally available in primary care.