RESEARCH - Anti-CCP antibody testing useful for diagnosing rheumatoid arthritis

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Anti-CCP Antibody Testing Useful for Diagnosing Rheumatoid Arthritis

NEW YORK (Reuters Health) Jan 11 - Testing for anti-cyclic citrullinated

peptide (CCP) antibodies can accurately diagnose rheumatoid arthritis, new

research shows. To identify the disease at an early stage, however, combined

testing for anti-CCP antibodies and rheumatoid factor (RF) may be optimal.

The accuracy of such testing stems from anti-CCP antibodies being highly

specific for rheumatoid arthritis. The sensitivity, by contrast, is lower

than with RF, particularly for very early RA.

As reported in The Journal of Rheumatology for December, Dr. Toshihiro

Matsui, from Sagamihara National Hospital in Japan, and colleagues compared

the diagnostic utility of anti-CCP antibodies with other serologic markers

in 262 patients with rheumatoid arthritis and in 116 patients with other

rheumatic diseases. The rheumatoid arthritis group included 55 with very

early disease, defined as duration less than 6 months with no prior

treatment.

The presence of anti-CCP antibodies was 82.4% and 67.3% sensitive for total

rheumatoid arthritis and very early disease, respectively. Both RF and

anti-agalactosyl antibodies had higher sensitivities.

The specificity and positive predictive value for anti-CCP antibodies were

among the highest for any of the markers tested. The overall accuracy of

anti-CCP antibodies was 82.5%, which was higher than any of the other

markers alone or combined.

" Like the earlier discovery of RF, the strong association of anti-citrulline

antibodies in rheumatoid arthritis challenges us to examine how the immune

response to citrullined polypeptides is involved in the pathogenesis of the

disease, and how reliable anti-citrulline antibodies are in its early

diagnosis and in predicting its progression, " Dr. A. Bell, from St.

ph's Health Care London in Ontario, Canada, comments in a related

editorial.

J Rheumatol 2007;33:2369-2371,2390-2397

http://www.medscape.com/viewarticle/550669

Not an MD