Johansson L, et al. - In this study, the connections amongst RANKL and ACPA, anti-carbamylated protein antibodies (anti-CarP), cytokines and chemokines were examined in individuals before the onset of RA symptoms, and their relationship with radiological findings at disease onset was evaluated. It was concluded that the RANKL concentrations were increased several years before symptom onset for RA, especially in ACPA/RF/anti-CarP-positive individuals, all detectable earlier than RANKL. Positivity for RANKL and anti-CarP antibodies yielded the highest Larsen score at disease onset.