Rheumatoid arthritis
BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.
Rheumatoid arthritis
Laboratory tests
- FBC
- CRP
- Rheumatoid factor
- Anti-CCP antibodies
- Antinuclear antibodies (ANA)
- Serum creatinine with eGFR
- AST
- ALT
- Urine dipstick
Do not order
- ESR: cited with CRP by the HAS in 2007 [3], but no longer in the NABM (no active procedure in version 105) [5]; CRP is prescribed instead.
- Rheumatoid factor and anti-CCP antibodies repeated once positivity is established: their status varies little over the years and there is no point in repeating the test [2]; in the French ESPOIR cohort (775 early arthritis patients, tests every 6 months for 2 years), only 2.6% of patients without anti-CCP at baseline acquired them, and repetition very rarely provides information [9]. If the initial test is negative, a single repeat test in the first few years may be discussed [2].
Sources (9)
- Prévalence, mortalité et traitement des patients atteints de polyarthrite rhumatoïde
- Collège français des enseignants en rhumatologie (COFER). Item 196 : Polyarthrite rhumatoïde. Référentiel en ligne du Collège (lecofer.org), consulté le 13 octobre 2026.
- Polyarthrite rhumatoïde (PR) : diagnostic et prise en charge initiale
- Recommandations 2024 de la SFR sur la polyarthrite rhumatoïde
- Assurance maladie. Nomenclature des actes de biologie médicale (NABM), version 105 : acte 1827 (anticorps antipeptides cycliques citrullinés) ; absence d'acte actif pour la vitesse de sédimentation.
- National Institute for Health and Care Excellence (NICE). Rheumatoid arthritis in adults: management. NICE guideline NG100, 11 juillet 2018 (dernière mise à jour indiquée : 12 octobre 2020 ; une recommandation de traitement revue en 2024).
- Wasserman A. Rheumatoid Arthritis: Common Questions About Diagnosis and Management. Am Fam Physician. 2018;97(7):455-462.
- Peterson E, Gallagher MK, Wilbur J. Rheumatoid Arthritis: Diagnosis and Management for the Family Physician. Am Fam Physician. 2024;110(5):515-526.
- Gossec L, Paternotte S, Combe B, Meyer O, Dougados M. Repeated anticitrullinated protein antibody and rheumatoid factor assessment is not necessary in early arthritis: results from the ESPOIR cohort. J Rheumatol 2014;41(1):41-6.