title: Diagnostic value and clinical significance of anti-CCP in patients with advanced rheumatoid arthritis.
abstract: OBJECTIVE
  To investigate the prevalence of anticyclic citrullinated peptide (anti-CCP) in patients with advanced rheumatoid arthritis (RA) and to compare it with those in control subjects. Further, to study the relation between the anti-CCP and the disease activity parameters in these patients.
  
  
  METHODS
  Seventy-six RA patients who had a mean disease duration of 9.8 years were included. Eighty-three age-matched non-RA volunteers were enrolled as the control group. Disease duration, duration of morning stiffness, swollen and tender joint counts, hand deformity, patient's assessment of pain, anti-CCP, rheumatoid factor (RF) and acute phase proteins were evaluated. The functional disability was also assessed with the Modified Health Assessment Questionnaire (HAQ).
  
  
  RESULTS
  Thirty-seven sera (48.7%) in the patient group and one serum (1.2%) in the control group were positive for anti-CCP. RF was positive in 45% of the RA cases and in 5% of controls. Sensitivity and specificity of anti-CCP reactivity for RA were 49.0% and 99.0%, respectively. HAQ score and duration of morning stiffness were found to be significantly associated with anti-CCP positivity. Disease duration, swollen joint count and anti-CCP positivity were the most important variables predicting hand deformity.
  
  
  CONCLUSIONS
  The prevalence, sensitivity and specificity of anti-CCP in patients with advanced RA were found to be similar to those reported in patients with early disease. Anti-CCP was significantly associated with some parameters of both disease activity and severity. Anti-CCP might be a useful parameter in clinical evaluation of patients with advanced RA.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Central Laboratory, Aldeniz University School of Medicine, Turkey. nehirsamanci@akdeniz.edu.tr
authors.forename: Nehir
authors.initials: N
authors.lastname: Samanci
authors.forename: Sebahat
authors.initials: S
authors.lastname: Ozdem
authors.forename: Halide
authors.initials: H
authors.lastname: Akbas
authors.forename: Derya
authors.initials: D
authors.lastname: Mutlu
authors.forename: Meral
authors.initials: M
authors.lastname: Gultekin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Arman
authors.forename: Levent
authors.initials: L
authors.lastname: Donmez
mesh_terms: D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000175:diagnosis; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002956:Citrulline / Q000097:blood*; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012217:Rheumatoid Factor / Q000097:blood; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D002956:Citrulline; D012217:Rheumatoid Factor