We observed higher serum levels of CCN4, VCAM-1, MMP3, and GM-CSF proteins in patients with RA with HAD (6133.3 ± 763.3 pg/mL, 2994.1 ± 788.2 ng/mL, 356.9 ± 175.4n g/mL, and 180.2 ± 31.5 pg/mL, respectively) rather than with LDA and MDA (P = 0.0001). This evidence concerns the gene CCN4 and rheumatoid arthritis.