Our findings revealed that the Val11-His13-Arg71-Ala74 haplotype was strongly associated with risk of ACPA-positive RA in the Malay (OR = 5.28, 95% CI = 3.06–9.09, p = 1.22 × 10−09), Chinese (OR = 10.33, 95% CI = 4.39–24.31, p = 9.81 × 10−09), and Indian (OR = 3.84, 95% CI = 3.75–4.75, p = 0.03) populations (Table 4). This evidence concerns the gene PRTN3 and rheumatoid arthritis.