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Survivin improves the early recognition of rheumatoid arthritis among patients with arthralgia: A population-based study within two university cities of Sweden.

Journal article
Authors Malin Erlandsson
Minna Turkkila
Filip Siljehult
Rille Pullerits
Catharina Eriksson
Solbritt Rantapää-Dahlqvist
Maria Bokarewa
Published in Seminars in arthritis and rheumatism
Volume 47
Issue 6
Pages 778-785
ISSN 1532-866X
Publication year 2018
Published at Institute of Medicine, Department of Rheumatology and Inflammation Research
Pages 778-785
Language en
Keywords Rheumatoid arthritis; Arthralgia; Survivin; Population-based study; Disease prediction; Auto-antibodies
Subject categories Rheumatology and Autoimmunity, Clinical Laboratory Medicine


The aim of this study was to validate the use of survivin for preclinical recognition of rheumatoid arthritis (RA) among patients with unexplained arthralgia.Serum levels of survivin and the arthritis-specific autoantibodies RF and ACPA were measured in total of 5046 patients with musculoskeletal complains during 12 consecutive months in Gothenburg and in Umeå. Among them, 303 arthralgia patients were identified and prospectively followed.After 48 months, 12.2% of the arthralgia patients developed RA. Most of RA cases had high serum survivin, which increased the relative risk for RA (RR = 5.90, p = 3 × 10-7). Combination of survivin with autoantibodies was present in only 4.6% of the arthralgia patients and increased further the risk of RA and shortened time to RA development. Presence of any single autoantibody in the survivin-negative patients was associated with a minor risk for RA and had RA-free survival similar to the reference group.This study shows that measurement of survivin in serum improves estimation of RA risk and prospectively predicts RA development in patients with arthralgia. Survivin may indicate a phase preceding autoantibody production.

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