What Type of RA Do You Have?

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 he finds out what your symptoms are.

Seronegative RA

Being seronegative means you don't have the anti-CCPs 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.

Similarities

No matter which diagnosis you get, your symptoms will probably be the same. These can include:

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 osteoarthritis. That's a joint disease where the cartilage on your bones has worn away, which causes joint stiffness.

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:

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).

These medications won't cure your RA. They'll just make the symptoms easier to deal with, or slow down the growth of the disease.

Your doctor may also prescribe:

As a last resort, you may have surgery on your joints or tendons.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on October 14, 2019

Sources

SOURCES:

National Rheumatoid Arthritis Society: "Seropositive and Seronegative."

Arthritis Foundation: "What 'Type' of RA Do You Have?"

Journal, Indian Academy of Clinical Medicine: "Approach to Seronegative Arthritis."

Mayo Clinic: "Rheumatoid Arthritis."

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