Disease continuum of seronegative rheumatoid arthritis: from development to prevention, from management to disease resolution

Autoantibody-negative rheumatoid arthritis (RA) accounts for up to 40% of contemporary RA cohorts and represents a distinct immunopathological entity rather than a seropositive disease lacking rheumatoid factor (RF) or anti-citrullinated protein antibodies (ACPA). While the disease continuum of RA—from genetic susceptibility and environmental exposures to clinically manifest arthritis, remission, or difficult-to-treat (D2T) disease—has been extensively characterized in seropositive patients, important gaps remain in the understanding of autoantibody-negative RA.