Diagnostic usefulness of a third-generation anti-cyclic citrulline antibody test in patients with recent-onset polyarthritis

Caro-Oleas, José Luis; Fernández-Suárez, Antonio; Cesteros, Sonsoles Reneses; Porrino, Carmen; Núñez‐Roldán, Antonio; Schlipf, Ingeborg Wichmann

doi:10.1515/cclm.2007.294

Cited by 18 publications

(13 citation statements)

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“…We identified 797 articles, of which 17 met the inclusion criteria [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]. There were 1952 RA patients selected from Europe, Americas and Asia in the remaining 17 articles that were eventually available for this meta-analysis (see Table 1).…”

Section: Search Results and Characteristics Of The Studiesmentioning

confidence: 99%

“…We reviewed the quality of the included articles that are of high level in terms of QUADAS rating. However, items 10 and 11 (index test results blinded and reference standard blinded to index test) of all studies except for one article [27] are "unclear". The two antibodies in eight articles [26, 27, 29, 32-34, 37, 38] were not described in detail, so they did not reach item 8 (adequate index test description).…”

Section: Discussionmentioning

confidence: 99%

“…One article [26] did not accord with item 14 as it did not explain withdrawals. Meanwhile, only two articles [27,40] were prospective studies and had different kinds of reference standard [3,[16][17][18][19]. It is reported that various characteristics of the control groups play important roles in sensitivity and specificity since the prevalence of anti-citrullinated peptide antibody differs from non-RA rheumatic diseases and from common infections and healthy individuals.…”

Section: Discussionmentioning

confidence: 99%

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Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide 2 antibody and anti-cyclic citrullinated peptide 3 antibody in rheumatoid arthritis

Zhang¹,

Chen

2014

Clinical Chemistry and Laboratory Medicine (CCLM)

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Abstract:The aim of this work was to assess the diagnostic value of anti-CCP-3 and anti-CCP-2 for the diagnosis of rheumatoid arthritis (RA) and determine whether anti-CCP-3 more accurately identifies patients with rheumatoid arthritis than anti-CCP-2. PubMed and CNKI databases were searched for studies published in English and Chinese that examined the use of anti-CCP-3 and anti-CCP-2 in the diagnosis of known or suspected rheumatoid arthritis from January 2006 to July 2013. Seventeen included studies of methodological quality were rated by using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tools A randomeffects method was used to summarize sensitivities, specificities, positive and negative likelihood ratio (LR+ and LR-, respectively), and diagnostic odds ratio from 17 studies. The pooled sensitivity, specificity, LR+, LR-and diagnostic odds ratio for anti-CCP-3 were 0.737 (95% CI, 0.717-0.757), 0.933 (95% CI, 0.924-0.942), 11.096 (95% CI, 0.274 (95% CI, and 42.908 (95% CI,, respectively. For anti-CCP-2, the values were 0.719 (95% CI, 0.699-0.739), 0.960 (95% CI, 0.953-0.966), 17.485 (95% CI, 0.294 (95% CI,), respectively. With high specificity and moderate sensitivity, anti-CCP-2 and anti-CCP-3 played an important role in confirming the diagnosis of RA. Anti-CCP-3 did not have better diagnostic performances than anti-CCP-2, but anti-CCP-2 had evident heterogeneity compared to anti-CCP-3, especially in American patients.

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Section: Search Results and Characteristics Of The Studiesmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide 2 antibody and anti-cyclic citrullinated peptide 3 antibody in rheumatoid arthritis

Zhang¹,

Chen

2014

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…At this time it is difficult to interpret the additional value provided by anti-CCP3, except that it is most likely equivalent to anti-CCP2 in terms of overall sensitivity and specificity for RA 20,21,22 . In our study, the difference in sensitivity and specificity between the 2 tests was not statistically significant, although consistently more specimens were anti-CCP3+ than anti-CCP2+ (Table 1) in both the RA and control groups.…”

Section: Discussionmentioning

confidence: 99%

“…It has also been well documented and widely reported that about one-third of RF-RA patients are anti-CCP2+ 19 . Recently, another synthetic citrullinated peptide, CCP3, has been utilized as antigen in a third-generation assay and has been shown to have similar sensitivity and specificity to CCP2 for RA 20,21,22 . However, the relationships among anti-CCP2, anti-CCP3, and rheumatoid factors has not yet been investigated.…”

Section: Rheumatologymentioning

confidence: 99%

Relationship Between Rheumatoid Factor Isotypes and IgG Anti-Cyclic Citrullinated Peptide Antibodies

Jaskowski¹,

Hill²,

Russo³

et al. 2010

J Rheumatol

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Objective.To validate in a general patient population (GPP) the clinical value of measuring rheumatoid factor (RF) isotypes in relationship to IgG anti-cyclic citrullinated peptide (CCP) antibodies (CCP2 and CCP3).Methods.Serum samples were obtained as follows: 1021 GPP, for whom RF was ordered for diagnosis, 137 with rheumatoid arthritis (RA), 100 healthy blood donors (HBD), and 50 with systemic lupus erythematosus. Turbidimetry and ELISA were utilized for RF screening, and individual RF isotypes and IgG anti-CCP antibodies were measured by ELISA; RF IgG was measured after pepsin digestion.Results.We validated the generally accepted 90%–98% positive predictive value (PPV) and about 68% sensitivity of the anti-CCP2 test on our diagnosed cohorts as 96% (95% CI 89–99) and 65% (95% CI 56–73), respectively. The 282 RF IgM+ specimens identified in the GPP were subdivided into 3 subsets: (1) 83 as RF IgM+ IgG+ IgA+ with 63% (95% CI 51–73) anti-CCP2+ (i.e., sensitivity similar to the RA cohort); (2) 50 as RF IgM+ IgG− IgA+ with significantly fewer anti-CCP2+ (22%; 95% CI 12–36); and (3) about half as IgM+ IgG− IgA− with just 3% (95% CI 1–8) anti-CCP2+, i.e., not significantly different from the 1% (95% CI 0–5) in HBD. Thus, the chance for a specimen in the GPP to be anti-CCP2+ (i.e., to come from an RA patient) was increased by 7- and 21-fold, respectively, by identifying RF IgA and IgG in addition to IgM. About one-third of anti-CCP− RA patients in our cohort were RF IgM+ IgG+ IgA+, reflected as 3.4% in the anti-CCP2− GPP. The agreement between anti-CCP2 and anti-CCP3 was significantly higher for RF+ RA and GPP patients, 86% (95% CI 78–93) and 83% (95% CI 73–91), respectively, than for the RF− RA (27%; 95% CI 6–61), RF− GPP (4%; 95% CI 0–19), and non-RA controls. Anti-CCP2 but not anti-CCP3 significantly distinguished the HBD from the GPP (95% CI).Conclusion.Measurement of the 3 isotypes of RF may increase by 7- to 21-fold the chance of making the serologic diagnosis of RA; a testing algorithm is proposed. The anti-CCP antibody response appears significantly less peptide-specific in the presence of IgM RF than in its absence.

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Dinnes¹,

Deeks²,

Leeflang³

et al. 2023

Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy

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Diagnostic usefulness of a third-generation anti-cyclic citrulline antibody test in patients with recent-onset polyarthritis

Abstract: Testing with both types of anti-CCP kit is highly specific for the presence of RA. In our ROP group, anti-CCP2 and anti-CCP3 exhibited similar diagnostic efficiency.

Cited by 18 publications

References 2 publications

Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide 2 antibody and anti-cyclic citrullinated peptide 3 antibody in rheumatoid arthritis

Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide 2 antibody and anti-cyclic citrullinated peptide 3 antibody in rheumatoid arthritis

Relationship Between Rheumatoid Factor Isotypes and IgG Anti-Cyclic Citrullinated Peptide Antibodies

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