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DIAGNOSTIC AND PROGNOSTIC VALUE OF ANTI-CYCLIC CITRULLINATED PEPTIDE AND RHEUMATOID FACTOR IN RHEUMATOID ARTHRITIS

S Omer1, A Abdrabo2, A Omar3

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Anti-cyclic citrullinated peptide (anti-CCP) antibodies are highly specific for rheumatoid arthritis (RA) diagnosis, especially in advanced stages. Combining anti-CCP and rheumatoid factor (RF) tests improves diagnostic accuracy for RA.

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Area of Science:

  • Rheumatology
  • Immunology
  • Clinical Diagnostics

Background:

  • Rheumatoid arthritis (RA) diagnosis relies on clinical evaluation and serological markers.
  • Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies are key autoantibodies in RA.
  • Assessing the diagnostic and prognostic utility of these markers is crucial for patient management.

Purpose of the Study:

  • To evaluate the diagnostic and prognostic value of RF and anti-CCP antibodies in rheumatoid arthritis (RA).
  • To focus on the role of these autoantibodies in early RA diagnosis and disease activity assessment.
  • To compare the efficacy of RF and anti-CCP in differentiating RA from healthy controls and early RA.

Main Methods:

  • An analytical case-control study was conducted with 166 RA patients, 68 early RA patients, and 166 healthy controls.
  • Measurements included RF, anti-CCP antibodies, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR).
  • Statistical analyses involved chi-square, Kruskal-Wallis, and receiver operating characteristic (ROC) curve analyses.

Main Results:

  • RF and anti-CCP levels were significantly higher in established RA patients compared to early RA and controls (p < 0.001).
  • Anti-CCP antibodies demonstrated superior specificity (98%) for RA diagnosis compared to RF (79%).
  • In established RA, anti-CCP sensitivity (79%) exceeded RF sensitivity (67%), though many early RA patients were negative for both; CRP and ESR were more indicative in early stages.

Conclusions:

  • Anti-CCP antibodies are highly specific for rheumatoid arthritis, particularly in progressed disease.
  • Combining RF and anti-CCP testing enhances diagnostic accuracy for RA.
  • Both markers are valuable for RA prognosis, disease activity evaluation, and early diagnosis in clinical practice.