Article in Medscape The presence of at least five dominant B-cell receptor (BCR) clones in peripheral blood predicted the short-term onset of rheumatoid arthritis. The findings confirm results from a study of 21 people with autoantibodies indicating risk for rheumatoid arthritis (Ann Rheum Dis. 2017;76:1924-1930). "We think that peripheral BCR clones can be used to identify at-risk individuals who will go on to develop arthritis," Musters said in a statement. This information could be used to evaluate "early interventions to prevent the onset of disease." In their study, Musters and her colleagues used next-generation sequencing to evaluate BCR clones in 129 people with joint pain and rheumatoid arthritis-specific antibodies. Of these, 45 people tested positive— defined as at least five dominant BCR clones — and 84 tested negative. During the 104-month follow-up period, patients in the positive group were more likely to develop rheumatoid arthritis than those in the negative group (76% vs 13%; relative risk, 5.8; 95% confidence interval, 3.2 - 10.3; P < .0001). In addition, the more BCR clones, "the higher the risk of imminent-onset arthritis," he reported. Having nine or more dominant BCR clones in the blood corresponded with a positive predictive value of 91% for development within 3 years.