Abstract
Rheumatoid arthritis is multifactorial and is the most common chronic inflammatory rheumatic disease. In many patients, two elements are central in the development of rheumatoid arthritis: autoantibodies directed against citrulline residues (anti-citrullinated peptide antibodies [ACPAs]),1 which can be detected in serum up to 15 years before the onset of clinical symptoms; and the presence of human leukocyte antigen (HLA)-DR alleles that express the so-called shared epitope that is associated with a high risk of developing rheumatoid arthritis.
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