If you've just been diagnosed with rheumatoid arthritis (RA), you may wonder what your future holds. The answer may lie in which of the two main types you have.
Seropositive RA
This is the more common type (60%-80% of people with RA are seropositive). Having seropositive RA means your blood has antibodies that can attack your body and inflame your joints. They're called anti-cyclic citrullinated peptides (your doctor may call them anti-CCPs), or anti-citrullinated protein antibodies (ACPAs).
Your doctor can give you a blood test to see if you have anti-CCPs. But having them doesn't always mean you have RA. Your doctor will make that call after they find out what your symptoms are suffering from.
Seronegative RA
Being seronegative means you don't have the anti-CCPs or rheumatoid factor in your blood at all -- or you don't have much of them. If you still have RA symptoms and a negative test for anti-CCPs, then you probably have seronegative RA or even another diagnosis.
Similarities
No matter which diagnosis you get, your symptoms will probably be the same. These can include:
- Joint pain
- Joint stiffness
- Body stiffness in the morning for 30 minutes or more
- Inflammation of the body in other areas besides the joints
- Fatigue
Differences
People with seropositive RA usually have more pain than those with the seronegative kind. They're also more likely to:
- Have nodules (swollen lumps under the skin)
- Have vasculitis (inflamed blood vessels)
- Have rheumatoid lung issues
- Have other illnesses along with their RA, like cardiovascular disease. Smokers are also more likely to get seropositive RA
If you're seronegative, but have RA symptoms, you could have another condition. For instance, if you're seronegative but have inflammation in your body, you could have psoriatic arthritis. That's a chronic disease related to psoriasis that causes joint pain and stiffness, skin rashes, and changes in the fingernails and toenails.
Treatment
No matter which type of RA you have, your treatment will likely be the same.
You'll be prescribed one or more of the following treatments:
- An anti-inflammatory medication (NSAID), like ibuprofen or naproxen
- A corticosteroid medication, like prednisone
- A traditional disease-modifying antirheumatic drug (DMARD) such as methotrexate (Trexall, Otrexup, Rasuvo) or leflunomide (Arava)
Your doctor may prescribe biologic DMARD therapies. There is some evidence that people who are seronegative don't respond as well to the DMARD rituximab (Mabthera). Synthetic targeted DMARDs such as JAK inhibitors are also available.
These medications won't cure your RA. They'll just make the symptoms easier to deal with, or slow down the progress of the disease.
Your doctor may also prescribe:
- Physical therapy
- Exercise
- Hot and cold compresses to help with the pain
