The diagnostic utility of the anti-CCP antibody test is no better than rheumatoid factor in South Africans with early rheumatoid arthritis.

Clinical Rheumatology
Bridget HodkinsonMohammed Tikly

Abstract

To establish the diagnostic utility of the anti-cyclic-citrullinated peptide antibody (aCCP) test in Black South Africans with early rheumatoid arthritis (RA). A cross-sectional study comparing the rheumatoid factor (RF) and aCCP status in RA patients and a control group consisting of healthy subjects, and patients with systemic lupus erythematosus (SLE) and scleroderma. The sensitivity, specificity, positive (PPV) and negative predictive values of the aCCP test alone were 82.5%, 84.9%, 87.6% and 79% versus 81.7%, 90.7%, 92.5% and 78% for RF alone. The best specificity (95.3) and PPV (95.8%) was observed when both aCCP and RF tests were positive. Patients with erosive disease had a significantly higher mean RF titre compared with those with non-erosive disease (p = 0.007). There was a trend towards an association of smoking (OR = 4.1, 95% CI = 0.9-18.6) and functional disability (p = 0.07) with RF-positive status. No similar clinical associations were observed with aCCP. Almost a third of SLE patients were aCCP positive. Despite the best specificity and PPV observed when both the aCCP and RF tests were positive, our findings suggest that testing for aCCP is only cost-effective in the RF-negative patient in whom there is a stron...Continue Reading

References

Feb 1, 1992·Annals of the Rheumatic Diseases·D M van der HeijdeL B van de Putte
Jan 22, 2000·Arthritis and Rheumatism·G A SchellekensW J van Venrooij
May 10, 2005·Annals of the Rheumatic Diseases·V P K NellG Steiner
Apr 17, 2007·QJM : Monthly Journal of the Association of Physicians·T B NiewoldS A Paget
Feb 28, 2009·QJM : Monthly Journal of the Association of Physicians·B HodkinsonM Tikly
Apr 11, 2009·Indian Journal of Medical Sciences·Rajiva GuptaP J Chandrasenan
Jul 15, 2009·Rheumatology International·Monchand VanichapuntuSuchela Janwityanujit

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Citations

Feb 10, 2016·Rheumatology International·Pieter W A MeyerRonald Anderson
May 6, 2015·International Journal of Rheumatic Diseases·Pi-Yueh ChangKuang-Hui Yu
Mar 5, 2014·Clinical Immunology : the Official Journal of the Clinical Immunology Society·Leonor NogueiraGuy Serre
Sep 19, 2019·Dento Maxillo Facial Radiology·Mostafa Mahmoud Youssef MohamedAdel Mahmoud Ali Elsayed

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