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Few individuals seroconverted from negative to positive (ACPA 2% and IgM RF 5%) and positive to negative (ACPA 3% and IgM RF 6%). CONCLUSIONS ACPA has a higher PPV for RA than IgM RF, whereas their NPV is identical. ACPA is the better choice when testing for RA in primary care. Seroconversion is rare, and it is only rarely relevant to retest. FUNDING The Department of Clinical immunology at Odense University Hospital funded the study. TRIAL REGISTRATION not relevant. Articles published in the DMJ are “open access”. This means that the a