To Assess the Sensitivity and Specificity of Serum Anticyclic Citrullinated Peptide Antibody in Patients With Rheumatoid Arthritis in a Community Hospital in Lahore, Pakistan

Abstract

OBJECTIVES: To compare the sensitivity and specificity of serum anti-Cyclic Citrullinated Peptideantibody (anti-CCP) with serum rheumatoid factor in diagnosing rheumatoid arthritis (RA) in acommunity hospital in Lahore, Pakistan.DESIGN: Cross-sectional analytical study.PLACE & DURATION OF STUDY: Subjects were recruited from Fatima Memorial Hospital,Rheumatology Outpatient Department from January, 2010 to December, 2010. The research work wasconducted at Department of Physiology and Cell Biology of University of Health Sciences, Lahore.SUBJECTS & METHODS: Eighty diagnosed patients of rheumatoid arthritis and thirty normalhealthy controls were included in the study. After selection of subjects, written informed consent wasobtained. The venous blood sample was taken and secured in vacutainers. Serum was extracted bycentrifugation and stored at -20°C till analysis. Titers of anti-CCP and rheumatoid factor weredetermined by ELISA. The data obtained was analyzed by using SPSS version 16.0.RESULTS: The sensitivity and specificity of serum anti-CCP was found to be 58.6% and 86.7%respectively as compared to 47.5% and 83.3% for serum rheumatoid factor (RF) in diagnosingrheumatoid arthritis. Sensitivity of anti-CCP antibody in RF negative sub-group was 32.1%.CONCLUSION: Serum anti-CCP antibody is more sensitive and specific marker for diagnosis ofrheumatoid arthritis as compared to the rheumatoid factor.KEY WORDS: Rheumatoid Arthritis, Anti- Cyclic Citrullinated Peptide Antibody (ACCP), Rheumatoid Factor