Abstract
Background: Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. About 1% of the world's population is afflicted by rheumatoid arthritis, women three times more often than men. Onset is most frequent between the ages of 40 and 50, but any age group can be affected. Aim of Work : To study the value of Anti cyclic citrullinated protein (Anti-CCP) test as a predictor of disease course, disability, prognosis and response to treatment in Rheumatoid arthritis patients of a specific age group with regard to history, clinical and radiological findings. The results for Anti-CCP will be compared to Rheumatoid factor test. Patients: 80 female cases were collected from rheumatology outpatient clinics, with disease duration of 3- 5 years and age range from 35 to 40 years Methods: All cases underwent thorough history taking, clinical examination, radiological and laboratory assessment as well as disability and health assessment scoring. Each patient will undergo a quantitative test of Anti cyclic citrullinated protein (Anti-CCP) and Rheumatoid factor. Results : Our study showed that there was high significant relation between positive and negative RF and Anti-CCP titres. (p=0.0000) for the patients in the studied group. There was a high significant correlation between Anti-CCP and RF titres (r=0.81, p<0.05) Also there was a significant correlation between Anti-CCP and ACR disability class. In addition, there was a positive but not significant correlation between Anti-CCP and STLW score. (Clinical findings score- Swelling, Tenderness, limitation of movement, Warmth) and with VAS (Visual analogue scale) Conclusion: Our study found that Anti-CCP has a reasonably good prognostic value, especially as regards disability and functional status prediction. It also showed that Anti-CCP is very comparable to Rheumatoid factor when comparing prognostic values. It is only slightly more indicative in terms of clinical, radiological and health assesment.
Highlights
Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints
One study using a CCP1 assay showed a sensitivity of 55% and a specificity of 97% for RA, when both anti-CCP and IgM RF were positive in the early stage of arthritis (Jansen et al, 2002)
In the present study we aimed to investigate the vealue of Anti-CCP as a prognostic factor in Rheumatoid Arthritis and compare the results with Rheumatoid factor test
Summary
Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The specificity of anti-CCP is around 95-98% as regards undifferentiated forms of arthritis that do not develop into RA. One study using a CCP1 assay showed a sensitivity of 55% and a specificity of 97% for RA, when both anti-CCP and IgM RF were positive in the early stage of arthritis (Jansen et al, 2002). Several observations have indicated that anti-CCP positive early RA patients may develop a more erosive disease than those without anti-CCP. Other investigators have confirmed this, and suggested the superiority of anti-CCP over IgM RF in predicting an erosive disease course. The use of anti-CCP results in the decision whether a patient should be treated aggressively at an early stage or not is an important area for research (Kroot et al, 2000). Onset is most frequent between the ages of 40 and 50, but any age group can be affected
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