Challenging the One-Size-Fits-All Approach in Rheumatoid Arthritis Management by Addressing Serostatus-Driven Differences
International rheumatoid arthritis (RA) guidelines do not differentiate treatment strategies based on serostatus, despite distinct disease differences between seronegative and seropositive patients. These groups vary in cellular abnormalities, immunologic and genetic profiles, and therapeutic respon...
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| Format: | Article |
| Language: | English |
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Romanian Association of Balneology, Editura Balneara
2025-06-01
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| Series: | Balneo and PRM Research Journal |
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| Online Access: | https://bioclima.ro/Balneo803.pdf |
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| author | Andrei-Flavius Radu Ada Radu Carmen Delia Nistor-Cseppento Delia Mirela Tit Lavinia Cristina Moleriu Nicoleta Anamaria Pascalau Radu Dumitru Moleriu Simona Gabriela Bungau |
| author_facet | Andrei-Flavius Radu Ada Radu Carmen Delia Nistor-Cseppento Delia Mirela Tit Lavinia Cristina Moleriu Nicoleta Anamaria Pascalau Radu Dumitru Moleriu Simona Gabriela Bungau |
| author_sort | Andrei-Flavius Radu |
| collection | DOAJ |
| description | International rheumatoid arthritis (RA) guidelines do not differentiate treatment strategies based on serostatus, despite distinct disease differences between seronegative and seropositive patients. These groups vary in cellular abnormalities, immunologic and genetic profiles, and therapeutic responses. The present study aims to target differences in RA severity, suggesting a need for personalized treatment approaches. A retrospective cohort study of 117 RA patients (seronegative n=55, seropositive n=62) was conducted over four years, during which all patients were treated with combinations of DMARDs. Seronegativity was defined by the absence of rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA), while seropositivity was defined by the presence of at least one antibody. Disease severity parameters, including morning stiffness, Health Assessment Questionnaire (HAQ), Disease Activity Score in 28 joints (DAS28), Simplified Disease Activity Index (SDAI), and Visual Analogue Scale (VAS), were assessed annually. Seronegative patients were older, had a higher body mass index, and experienced later disease onset. At baseline, disease severity indicators, including morning stiffness, HAQ, DAS28, SDAI, and VAS, were significantly lower in seronegative patients (p <0.05). Disease severity improved over the years in both groups, with significant changes only in the first year. Autoantibodies like RF and ACPA correlated with more severe disease and a higher risk of unfavorable progression. These findings support personalized therapeutic strategies. Further research should explore whether seronegative RA patients require alternative treatment and rehabilitation due to their milder disease course. |
| format | Article |
| id | doaj-art-705fdf34aa5e4e77b9e0cd9fda6fabfc |
| institution | Kabale University |
| issn | 2734-8458 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Romanian Association of Balneology, Editura Balneara |
| record_format | Article |
| series | Balneo and PRM Research Journal |
| spelling | doaj-art-705fdf34aa5e4e77b9e0cd9fda6fabfc2025-08-20T03:33:34ZengRomanian Association of Balneology, Editura BalnearaBalneo and PRM Research Journal2734-84582025-06-0116280310.12680/balneo.2025.803Challenging the One-Size-Fits-All Approach in Rheumatoid Arthritis Management by Addressing Serostatus-Driven DifferencesAndrei-Flavius Radu0Ada Radu1Carmen Delia Nistor-Cseppento2Delia Mirela Tit3Lavinia Cristina Moleriu4Nicoleta Anamaria Pascalau5Radu Dumitru Moleriu6Simona Gabriela Bungau7Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, Univer-sity of Oradea, 410073 Oradea, RomaniaDoctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, RomaniaDoctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, Univer-sity of Oradea, 410073 Oradea, RomaniaDoctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, RomaniaDepartment III of Functional Sciences, Discipline of Medical Informatics and Biostatistics, ‘’Vic-tor Babes’’ University of Medicine and Pharmacy, 300041 Timisoara, RomaniaDepartment of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, Univer-sity of Oradea, 410073 Oradea, RomaniaFaculty of Mathematics and Computer Science, Department of Computer Science, West Univer-sity of Timisoara, 300223, Timisoara, RomaniaDoctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, RomaniaInternational rheumatoid arthritis (RA) guidelines do not differentiate treatment strategies based on serostatus, despite distinct disease differences between seronegative and seropositive patients. These groups vary in cellular abnormalities, immunologic and genetic profiles, and therapeutic responses. The present study aims to target differences in RA severity, suggesting a need for personalized treatment approaches. A retrospective cohort study of 117 RA patients (seronegative n=55, seropositive n=62) was conducted over four years, during which all patients were treated with combinations of DMARDs. Seronegativity was defined by the absence of rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA), while seropositivity was defined by the presence of at least one antibody. Disease severity parameters, including morning stiffness, Health Assessment Questionnaire (HAQ), Disease Activity Score in 28 joints (DAS28), Simplified Disease Activity Index (SDAI), and Visual Analogue Scale (VAS), were assessed annually. Seronegative patients were older, had a higher body mass index, and experienced later disease onset. At baseline, disease severity indicators, including morning stiffness, HAQ, DAS28, SDAI, and VAS, were significantly lower in seronegative patients (p <0.05). Disease severity improved over the years in both groups, with significant changes only in the first year. Autoantibodies like RF and ACPA correlated with more severe disease and a higher risk of unfavorable progression. These findings support personalized therapeutic strategies. Further research should explore whether seronegative RA patients require alternative treatment and rehabilitation due to their milder disease course.https://bioclima.ro/Balneo803.pdfanti-citrullinated protein antibodiesdmardsrheumatoid arthritisrheu-matoid factorseronegative raseropositive ra |
| spellingShingle | Andrei-Flavius Radu Ada Radu Carmen Delia Nistor-Cseppento Delia Mirela Tit Lavinia Cristina Moleriu Nicoleta Anamaria Pascalau Radu Dumitru Moleriu Simona Gabriela Bungau Challenging the One-Size-Fits-All Approach in Rheumatoid Arthritis Management by Addressing Serostatus-Driven Differences Balneo and PRM Research Journal anti-citrullinated protein antibodies dmards rheumatoid arthritis rheu-matoid factor seronegative ra seropositive ra |
| title | Challenging the One-Size-Fits-All Approach in Rheumatoid Arthritis Management by Addressing Serostatus-Driven Differences |
| title_full | Challenging the One-Size-Fits-All Approach in Rheumatoid Arthritis Management by Addressing Serostatus-Driven Differences |
| title_fullStr | Challenging the One-Size-Fits-All Approach in Rheumatoid Arthritis Management by Addressing Serostatus-Driven Differences |
| title_full_unstemmed | Challenging the One-Size-Fits-All Approach in Rheumatoid Arthritis Management by Addressing Serostatus-Driven Differences |
| title_short | Challenging the One-Size-Fits-All Approach in Rheumatoid Arthritis Management by Addressing Serostatus-Driven Differences |
| title_sort | challenging the one size fits all approach in rheumatoid arthritis management by addressing serostatus driven differences |
| topic | anti-citrullinated protein antibodies dmards rheumatoid arthritis rheu-matoid factor seronegative ra seropositive ra |
| url | https://bioclima.ro/Balneo803.pdf |
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