Usefulness of anti -CCP antibodies in rheumatic diseases in Indian patients.
BACKGROUND
The usefulness of anti-cyclic citrullinated peptide antibodies (anti-CCP antibodies) to identify rheumatic arthritis (RA) from other rheumatic diseases presenting with joint pain is not well studied.


OBJECTIVE
We aimed to determine the sensitivity and specificity of anti-CCP antibodies in Indian RA patients with respect to non-RA rheumatic diseases and to study the relationship of anti-CCP antibodies and IgG, IgM and IgA rheumatoid factor in RA.


METHODS
Case-control cross-sectional study carried out in the rheumatology division of All India Institute of Medical Sciences.


METHODS
Sixty-three patients with rheumatoid arthritis (RA) and 51 patients with non-RA rheumatic diseases having joint pain were included in the study. Sera were tested for anti-CCP antibodies (IgG) and IgA, IgM, IgG rheumatoid factor, using a commercially available enzyme-linked immunosorbent assay.


METHODS
Statistical analysis was performed using SPSS statistical software version 11.5.


RESULTS
Fifty-four of 63 RA patients (85.71%) were positive for anti-CCP antibodies. In the non-RA group, anti-CCP antibody was positive in only 5 of 51 patients (9.8%). Our study found a sensitivity of 85% and a specificity of 90.19% with regard to the use of anti-CCP antibodies assay in patients with joint pain to correctly identify RA. Anti-CCP antibodies positive patients did not have more erosive disease. IgM-RF-positive patients had more erosion when compared to the IgM-RF-negative group. Thirty-two of 57 (56.1%) IgM-RF-positive patients had erosions, while no patient (0/6 patients) had erosions in the IgM-RF-negative group (P=0.01)


CONCLUSIONS
Anti-CCP antibodies have high sensitivity and specificity for diagnosis of RA, in Indian patients. Anti-CCP antibodies positive patients did not have more erosive disease in our study.
Gupta
Rajiva
R
Department of Medicine, Clinical Immunology and Rheumatology Services, All India Institute of Medical Sciences, New Delhi-110 029, India. guptarajiva@hotmail.com
Thabah
Molly M
MM
Aneja
Ritu
R
Kumar
Ashok
A
Varghese
Titus
T
Chandrasenan
P J
PJ
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood*; D006801:Humans; D010456:Peptides, Cyclic / Q000276:immunology*; D012216:Rheumatic Diseases / Q000175:diagnosis; D012217:Rheumatoid Factor / Q000097:blood; D012680:Sensitivity and Specificity
D001323:Autoantibodies; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D012217:Rheumatoid Factor