Language
English
Publication Date
8-1-2026
Journal
Arthritis Care & Research (AC&R) Journal
DOI
10.1002/acr.70011
PMID
41386743
PMCID
PMC12742836
PubMedCentral® Posted Date
3-15-2026
PubMedCentral® Full Text Version
Post-print
Abstract
Objective: The purpose of this study was to determine the cumulative incidence of diagnosis switching, drug-free remission, and initiation of a biologic or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) in individuals with seronegative rheumatoid arthritis (RA).
Methods: Adult residents of Olmsted County, Minnesota, with incident seronegative (rheumatoid factor negative/anti-cyclic citrullinated peptide antibody negative) RA meeting the 1987 and/or 2010 American College of Rheumatology classification criteria were included. Data were collected from January 1, 2005, to December 31, 2023, through manual chart review. Drug-free remission was defined as a period of at least six months where the individual was no longer taking treatment for RA and did not have evidence of active inflammatory arthritis upon evaluation by a rheumatologist. We calculated the 10-year cumulative incidence of a change in diagnosis, adjusting for the competing risk of death, and of drug-free remission and initiation of a b/tsDMARD, adjusting for the competing risks of death or change in diagnosis.
Results: A total of 176 individuals with seronegative RA (68% women) were included. The 10-year cumulative incidence of a change in diagnosis was 12.8% (95% confidence interval [CI] 8.7%-18.9%). The most common change in diagnosis was to spondyloarthritis (4%). The 10-year cumulative incidence of drug-free remission and initiation of a b/tsDMARD was 26.6% (95% CI 20.7%-34.2%) and 19.9% (95% CI 14.7%-26.9%), respectively. Over a median follow-up of 11.8 years, 49 individuals entered drug-free remission.
Conclusion: After initial diagnosis of seronegative RA, about 13% of individuals had a change in diagnosis and a quarter experienced drug-free remission within 10 years.
Keywords
Humans, Arthritis, Rheumatoid, Female, Male, Middle Aged, Antirheumatic Agents, Remission Induction, Adult, Treatment Outcome, Minnesota, Time Factors, Aged, Incidence, Rheumatoid Factor, Biological Products
Published Open-Access
yes
Recommended Citation
Kimbrough, Bradly A; George, Roslin Jose; Crowson, Cynthia S; et al., "Long-Term Outcomes in Seronegative Rheumatoid Arthritis" (2026). Faculty, Staff and Students Publications. 8417.
https://digitalcommons.library.tmc.edu/baylor_docs/8417