Diagnostic performance of anti-citrullinated peptide antibodies for the diagnosis of rheumatoid arthritis: the relevance of likelihood ratios

Abstract

The cut-off value of 2.8 U/mL for anti-CCP2 has the highest diagnostic accuracy. A value of anti-CCP2 >15 U/mL is associated with an increase in the likelihood of RA disease.

How well do ACPA discriminate and predict RA in the general population: a study based on 12 590 population-representative Swedish twins

“…One important advantage of the current study is the lack of any other positive or negative selection criteria, such as presence of other diseases or comorbidities. This is in contrast to previous studies reporting on ACPA diagnosis accuracy in either blood donors (where many diseases and infections that theoretically increase the risk of seropositivity are excluded2) or selected populations such as first-degree relatives of probands with RA,16 patients with other autoimmune diseases than RA45 and healthy individuals not having any kind of autoimmune diseases 46. Also, with some 12 590 individuals the current study is so far the largest to report on the diagnostic accuracy of ACPA (the majority of previous published studies included less than 500 healthy controls,6–8 45 only one study included 2358 healthy blood donors) 2.…”

Anticyclic Citrullinated Peptide Antibodies in Patients with Rheumatic Diseases other than Rheumatoid Arthritis: Clinical or Pathogenic Significance?

“…Although several studies have been published aiming to identify the prevalence of anti-CCP in patients with different rheumatic conditions 2,3,4 , Payet's study was performed in a very large patient cohort and represents, therefore, a relevant information source on this topic. The overall prevalence of anti-CCP in the 723 non-RA patients was rather high compared to other studies 5,6,7 , with a very high proportion of patients with connective tissue disease (CTD) with anti-CCP (17.5%). This allowed the conclusion that, although anti-CCP are rather specific for RA, they are consistently expressed in patients with other rheumatic diseases.…”

Unusual Draining Nodules in a Patient with Rheumatoid Nodulosis and Hepatitis C Virus Infection

“…Anti-CCP antibodies are not unique to RA. Low titers have been reported in psoriatic arthritis 12 and also even hepatitis C 13 . Our patient is unusual in that he has high-titer anti-CCP, but with no joint damage during 10 years mostly without immunosuppressive therapy.…”