High-Titer Rheumatoid Factor is Associated with Worse Clinical Outcomes and Higher Needs for Advanced Therapies in Rheumatoid Arthritis Under Real-Life Conditions

• Published in: Rheumatology and therapy. 2025-02, Vol.12 (1), p.123-136
• Main Authors: Oliveira, Victor Davi R. S., Reis, Ana Paula M. G., Brenol, Claiton V., Pereira, Ivânio A., Bonfiglioli, Karina R., Pereira, Letícia R., Bértolo, Manoel B., de Fátima L. C. Sauma, Maria, Guimarães, Maria Fernanda B. R., Louzada-Júnior, Paulo, Giorgi, Rina D. N., Radominski, Sebastião C., Mota, Licia Maria H., Albuquerque, Cleandro P., Castelar-Pinheiro, Geraldo R.
• Format: Article
• Language: English
• Subjects: Clinical outcomes; Cross-sectional study; Disease progression; Family Medicine; General Practice; Internal Medicine; Medicine; Medicine & Public Health; Original Research; Orthopedics; Prognosis; Quality of Life Research; Rheumatoid arthritis; Rheumatoid factor; Rheumatology; Steroids
• ISSN: 2198-6576; 2198-6584
• DOI: 10.1007/s40744-024-00730-w

Introduction Rheumatoid factor (RF) plays an important role in rheumatoid arthritis (RA) pathophysiology, yet the differential effects of varying RF titers remain understudied. We evaluated associations between different RF titers and clinical outcomes in long-standing RA. Methods This multicenter, cross-sectional study included adults meeting ACR/EULAR (2010) criteria for RA. Circulating RF titers and clinical-epidemiological characteristics were evaluated. Bivariate (Student’s t and chi-squared tests) tests and multiple logistic and linear regression analyses were conducted. Results We included 1097 participants; 78.7% had positive RF, with high titers (≥ 3 × the upper limit of normality) in 56.2%. Negative vs. low-positive RF groups performed similarly concerning all clinical outcomes, being subsequently aggregated as "non-high" RF group. High RF titers (compared to "non-high") were associated with tobacco use (odds ratio, OR [95% confidence interval, CI]: 2.04 [1.35, 3.08]; p