RESEARCH - Comparison of CCP1 and CCP2 Tests for RA

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Ann Rheum Dis. 2005 Mar 30; [Epub ahead of print]

A Comparison of the Diagnostic Accuracy and Prognostic Value of the First-

and Second Anti-Cyclic Citrullinated Peptides Autoantibody (CCP1 and CCP2)

Tests for Rheumatoid Arthritis.

van Gaalen FA, Visser H, Huizinga TW.

LUMC, Netherlands.

OBJECTIVES: Anti-citrulline autoantibodies are used for (early) diagnosis

and prognosis of rheumatoid arthritis (RA). Anti-citrulline antibodies can

be detected using ELISAs containing cyclic, citrullinated peptides (CCP).

Currently two generations of anti-CCP ELISAs (CCP1 and CCP2) are used but no

data are available to directly compare the two tests. We compared the

diagnostic performance and prognostic value of the anti-CCP1 and anti-CCP2

autoantibody tests in a clinical setting. METHODS: Anti-CCP1 and anti-CCP2

antibody test were performed on the same serum samples obtained from 467

early arthritis patients from the Leiden Arthritis Cohort. The sensitivity,

specificity, positive predictive value, and negative predictive value for

discriminating between RA and non-RA at one-year follow- up were calculated

for both tests. RESULTS: were graphically presented using receiver operating

characteristic (ROC) curves. Radiological joint damage progression was

assessed over a period of four years in patients with RA and used to assess

the prognostics values of the CCP tests. Results: At a similar specificity

the CCP2 test had a higher sensitivity than the CCP1 test. Both test

identified a sub-group of RA patients with an increased rate of joint damage

progression. As compared to the anti-CCP1, the anti-CCP2 test identified

more patients with an increased rate of joint damage progression and CCP2

was the best predictor in multiple regression analysis.

CONCLUSIONS: In terms of both diagnostic and prognostic ability, the

CCP2-test was superior to the CCP1 test.

PMID: 15800005

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5800005 & dopt=Abstract

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