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.
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.
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.
No matter which diagnosis you get, your symptoms will probably be the same. These can include:
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.
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 growth of the disease.
Your doctor may also prescribe:
As a last resort, you may have surgery on your joints or tendons.