In @entity50098 , XXXX are associated with severe and erosive @entity625 : an overlapping @entity309 and @entity50098 .

@entity1 @entity5442 @entity401 @entity625 @entity1223 @entity39 @entity262 @entity4841 @entity7134 @entity792 @entity309 @entity50098
Anticitrullinated peptide/protein antibodies ( @entity7134 ), which are highly specific for @entity309 ( @entity309 ), may be found in some @entity1 with other systemic @entity792 . The clinical significance of @entity7134 in patients with @entity50098 ( @entity50098 ), a @entity262 characterized by the association of @entity5442 , @entity401 , @entity4841 , and/or @entity625 , has not yet been evaluated with regard to phenotype, prognosis, and response to treatment. @entity7134 -positive @entity50098 @entity1 were first identified among a French multicenter registry of @entity1 with @entity50098 . Additionally, all French rheumatology and internal medicine practitioners registered on the Club Rhumatismes et Inflammation web site were asked to report their observations of @entity50098 @entity1 with @entity7134 . The 17 collected @entity1 were retrospectively studied using a standardized questionnaire and compared with 34 unselected @entity7134 -negative @entity50098 @entity1 in a case-control study. All @entity7134 -positive @entity50098 @entity1 suffered from @entity625 versus 41% in the control group (P<0.0001). The number of swollen joints was significantly higher (7.0  5.0 vs 2.9  3.9, P<0.005), with a distribution resembling that of @entity309 . Radiographic damages were also more frequent in @entity7134 -positive @entity50098 @entity1 (87% vs 11%, P<0.0001). Aside from a significantly higher transfer factor for @entity1223 in @entity7134 - @entity50098 @entity1 , lung, muscle, and skin involvements had similar incidences, patterns, and severity in both groups. Although Nonbiologic treatments were similarly used in both groups, @entity7134 -positive @entity1 received biologics more frequently (59% vs 12%, P<0.0008), mostly due to refractory @entity625 (n=9). Eight patients received anti-Cluster of differentiation 20 (CD20) monoclonal antibodies (mAbs) with good efficacy and tolerance, whereas 2 of the 5 @entity1 treated with antitumor @entity39 factor drugs had worsened @entity5442 and/or @entity401 . After a >7-year mean follow-up, extra-articular outcomes and survival were not different. @entity7134 -positive @entity50098 @entity1 showed an overlapping @entity309 - @entity50098 syndrome, were at high risk of @entity625 , and might experience @entity50098 flare when treated with antitumor @entity39 factor drugs. In contrast, other biologics such as anti-CD20 mAb were effective in this context, without worsening systemic involvements.
