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The goal of this study is to create a national network to study individuals at-risk for developing Rheumatoid Arthritis. This will be done through two objectives Objective #1) Establish the infrastructure to identify and follow antibodies to citrullinated protein antigens (ACPA) positive individuals who have been identified through routine care at rheumatology clinical practices or previously established research studies across the USA. This will provide data to inform objective #2 (see below) as well as serve as infrastructure that can be used in the future to recruit and enroll subjects for prevention and/or early treatment trials in RA. Objective #2) Develop robust predictive models for the 'real world' development of RA using clinical, environmental and biomarker (autoantibody and genetic) factors.

This study is designed to help us learn more about the development of rheumatoid arthritis (RA). This study is going to be a national study following people who have an abnormal blood test that is related to rheumatoid arthritis (RA). This test is called ‘anti-CCP’ and can be a marker for developing RA in the future. By studying people who have this abnormal CCP test, we hope that we will be able to develop better models for understanding the ‘real world’ development of RA. We plan to do this using clinical information, environmental information and results from blood tests done in this study to learn more about how RA develops, and ultimately how to prevent RA. Individuals can join the study from a variety of different paths, including identified through routine care at rheumatology clinical practices, previously established research studies across the USA, or can been tested through step 1 of this study where we test your CCP level.