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Arthritis Res Ther

, 5:24 | Cite as

Ability of second-generation anti-cyclic citrullinated peptide (CCP) to predict rheumatoid arthritis in patients with early arthritis

  • A Saraux
  • JM Berthelot
  • P Le Goff
  • P Youinou
Meeting abstract
  • 1.9k Downloads

Keywords

Peptide Rheumatoid Arthritis Arthritis Laboratory Test Likelihood Ratio 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Objective

We previously studied the diagnostic value of biological tests in RA and found that IgG-AKA, first generation of anti-CCP, IgM-RF by ELISA, and the latex test is the best combination in diagnosing RA. The goal of the present study was 1) to study the diagnostic value of the second generation of anti-CCP and 2) to determine the diagnostic value of second-generation anti-CCP used in combination in the same population.

Methods

A cohort of 270 patients with early arthritis underwent a standardized examination, laboratory tests and radiographs in 1995–1997. The final diagnosis was evaluated by a panel of five rheumatologists between June and December, 1999. The respective diagnostic values of antiperinuclear factor, antikeratin antibody, and anti-CCP (commercial kits: Eurodiagnostica first generation [EFG], Eurodiagnostica second generation [ESG], and Axis-Shield [AS]) carried out on sera taken at the patients' first visit in discriminating between patients who did (98/270; 36%) and did not have RA at the last visit was evaluated using receiving-operator characteristic curves. To evaluate the combination of anti-CCP with other laboratory tests in discriminating between patients with and without RA, a multiple logistic regression with backward selection using the likelihood ratio test was applied.

Results

1) Anti-CCP, APF and IgG AKA were not perfectly correlated with each other. For anti-CCP EFG (cutoff 53 UI), ESG (cutoff 0.120 OD), and AS (cutoff 0.320 OD), sensitivity and specificity were 47%-93%, 57%-94% and 58%-94%, respectively. 2) By the use of a multiple logistic regression, second generation anti-CCP, IgG-AKA, the latex test and IgM-RF ELISA were selected.

Conclusion

ESG and AS are the best tests for predicting RA. Combining one of these tests with IgG-AKA, IgM-RF, and the latex test slightly increases the diagnostic value.

Copyright information

© The Author(s) 2003

Authors and Affiliations

  • A Saraux
    • 1
  • JM Berthelot
    • 1
  • P Le Goff
    • 1
  • P Youinou
    • 1
  1. 1.Department of RheumatologyCentre Hospital UniversitaireBrestFrance

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