Hi saw2019,

You and I share the same titre of 320, and a speckled pattern. Since having been on Plaquenil (2018) my titre now falls within the near normal range. My high anti-CCP readings have turned negative. I still suffer with Sjogren’s symptoms, although no anti-SSA or -SSB antibodies are present. Never had any elevated inflammatory markers. The searing episodes of hand pain are gone, just some mild wrist and hand pain from time to time. The original diagnosis of Mixed Connective Tissue Disease (MCTD) was changed to Undifferentiated Connective Tissue Disease (UCTD), and here I remain!
Autoimmune disease is a very strange journey, and quite changeable. Symptoms and lab results come and go. I think the earlier you start treatment, the better the outcome. And don’t ignore diet and staying active. Look into alternative treatments. Above all, be prepared to get second, third, even fourth opinions. And good luck!