The earliest ANAs are anti-Ro/Sicca Syndrome (SS)-A and anti-La/SSB Abs, on average 3.7 years before, followed by anti-dsDNA Abs, on average 2.2 years before, and the anti-Smith (Sm) ribonucleoprotein (RNP) Abs, on average 0.9 years before the advent of clinical symptoms. Here, SSB is linked to synovial sarcoma.