We appreciate the interest of Noriaki Kou and colleagues [1] in our article [2], and we fully agree that beside disease activity, therapies, and systemic inflammation other non-traditional cardiovascular risk factors such as extra-articular manifestations and positivity for anti-citrullinated peptide antibodies (ACPA) and rheumatoid factor (RF) would negatively impact on the risk of future cardiovascular events in the RA population.
