Study of significance of anti-cyclic citrullinated peptide antibody in rheumatoid arthritis

Background: Early aggressive therapy is recommended for rheumatoid arthritis (RA). Rheumatoid factor (RF) is not very specific for RA diagnosis. Another test for RA diagnosis is assay for anti-cyclic citrullinated peptide antibodies (anti-CCP). Aims: Screening for anti-CCP and RF in clinically diagnosed RA patients and to determine the correlation between presence of these antibodies and joint erosion. Materials and Methods: Sera from 83 clinically diagnosed RA patients (by American College of Rheumatology 1987 criteria) were tested for RF and anti-CCP antibodies by commercially available latex agglutination and enzyme-linked immunosorbent assay kits, respectively. Results: Onset of RA at young age was seen ( P < 0.05). Seropositivity for anti-CCP in present study was 76%. Patients seronegative for RF but reactive to anti-CCP were 27.7%. Joint erosion was observed in 81.92% of RA cases. Joint erosion was more common in anti-CCP positive patients ( P < 0.001). Joint erosion was observed in all (100%) patients who were seropositive for both RF and anti-CCP. Conclusions: Anti-CCP antibody supports the diagnosis of RA when RF is negative. Joint erosion was observed to be more in RA cases seropostive for anti-CCP. Combined use of RF and anti-CCP is a better prognostic and diagnostic tool than conventional RF tests alone.