Clinical Use of Anti–Cyclic Citrullinated Peptide Antibody Testing

Peoples, C.E; Valiyil, Ritu; Davis, Roger B.; Shmerling, Robert H.

doi:10.1097/rhu.0b013e3182a22418

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…Therefore, we standardized all CCP antibody results by dividing by the ULN of the assay used to obtain the fold above the ULN. We stratified the CCP antibody level as low (>1 to 2× ULN), medium (>2 to 3× ULN), and high (>3× ULN) as clinically relevant cut points based on prior literature .…”

Section: Methodsmentioning

confidence: 99%

Impact of Cyclic Citrullinated Peptide Antibody Level on Progression to Rheumatoid Arthritis in Clinically Tested Cyclic Citrullinated Peptide Antibody–Positive Patients Without Rheumatoid Arthritis

Ford

Liu

Marshall

et al. 2019

Arthritis Care & Research

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Objective. To investigate the risk of progression to rheumatoid arthritis (RA) in patients who were cyclic citrullinated peptide (CCP) antibody positive without RA at initial presentation.Methods. We performed a retrospective cohort study of CCP+ individuals seen at a US tertiary care system between 2009 and 2018 who were without RA or other systemic rheumatic disease by medical record review at the time of CCP antibody positivity. Progression to classifiable RA was determined through medical record review. We investigated the risk of progression to RA overall and stratified by CCP antibody level (low: >1 to 2× the upper limit of normal [ULN]; medium: >2 to 3× ULN; high: >3× ULN). Multivariable Cox regression estimated the hazard ratio (HR) and 95% confidence interval (95% CI) for RA by CCP antibody level.Results. We identified 340 CCP+ patients who were without RA or other rheumatic disease at baseline. During 1,047 person-years of follow-up, 73 patients (21.5%) developed RA. The risk of progression to RA increased with CCP antibody level, with 46.0% (95% CI 34.7-55.3) of patients with high-level CCP antibodies progressing to RA by 5 years. Compared to low CCP antibody level, medium (HR 3.00 [95% CI 1.32-6.81]) and high (HR 4.83 [95% CI 2.51-9.31]) CCP antibody levels were strongly associated with progression to RA, adjusting for age, sex, body mass index, smoking, family history of RA, and rheumatoid factor level.Conclusion. Among CCP+ patients without RA, the risk for progression to RA increased substantially with increasing CCP antibody level. This study provides further support for close monitoring for development of RA among CCP+ patients and identifying strategies to mitigate this risk.

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Section: Methodsmentioning

confidence: 99%

Impact of Cyclic Citrullinated Peptide Antibody Level on Progression to Rheumatoid Arthritis in Clinically Tested Cyclic Citrullinated Peptide Antibody–Positive Patients Without Rheumatoid Arthritis

Ford

Liu

Marshall

et al. 2019

Arthritis Care & Research

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Rheumatoid Factors: Clinical Applications

2013

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Rheumatoid factors are antibodies directed against the Fc region of immunoglobulin G. First detected in patients with rheumatoid arthritis 70 years ago, they can also be found in patients with other autoimmune and nonautoimmune conditions, as well as in healthy subjects. Rheumatoid factors form part of the workup for the differential diagnosis of arthropathies. In clinical practice, it is recommended to measure anti-cyclic citrullinated peptide antibodies and rheumatoid factors together because anti-cyclic citrullinated peptide antibodies alone are only moderately sensitive, and the combination of the two markers improves diagnostic accuracy, especially in the case of early rheumatoid arthritis. Furthermore, different rheumatoid factor isotypes alone or in combination can be helpful when managing rheumatoid arthritis patients, from the time of diagnosis until deciding on the choice of therapeutic strategy.

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Clinical Use of Anti–Cyclic Citrullinated Peptide Antibody Testing

Cited by 2 publications

References 9 publications

Impact of Cyclic Citrullinated Peptide Antibody Level on Progression to Rheumatoid Arthritis in Clinically Tested Cyclic Citrullinated Peptide Antibody–Positive Patients Without Rheumatoid Arthritis

Impact of Cyclic Citrullinated Peptide Antibody Level on Progression to Rheumatoid Arthritis in Clinically Tested Cyclic Citrullinated Peptide Antibody–Positive Patients Without Rheumatoid Arthritis

Rheumatoid Factors: Clinical Applications

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