Purpose: To determine the value of Anti-CCP as predictor for disease activity in rheumatoid arthritis assessed by DAS-28, and to find the effect of smoking on disease activity in rheumatoid arthritis. Materials and Methods: One hundred patients with rheumatoid arthritis involved in this study, consisted of 88 female and 12 male who fulfilled the 2010 ACR-EULAR classification criteria for rheumatoid arthritis attending the rheumatology department in general hospital, or attended the center of rheumatology and rehabilitation in sulaimani city, for 6 months ( from October, 2012 to March, 2013). Thorough Demographic information of patients was recorded through history of age, sex, and history of smoking, disease duration, physical evaluation according to DAS-28. and serological test for RF and Anti-CCP. Results: There was highly significant association between DAS-28 and Anti-CCP value (p =0.0001). there was no significant correlation between DAS-28 and RF (p= 0.252),According to smoking there was highly significant association between smoking with Anti-CCP value and DAS-28 (p=0.003-0.0001) respectively while there was no significant association between smoking and RF(p=0.15). Conclusion: A highly significant correlation was found between Anti-CCP value and disease activity in rheumatoid arthritis, smoker patients had higher value of Anti-CCP compared to non-smoker patients. Smokers demonstrated a more active and severe disease activity compared to non-smokers.
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