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2017 ; 36
(7
): 1487-1492
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Anti-citrullinated protein antibodies in the diagnosis of rheumatoid arthritis
(RA): diagnostic performance of automated anti-CCP-2 and anti-CCP-3 antibodies
assays
#MMPMID28578492
Vos I
; Van Mol C
; Trouw LA
; Mahler M
; Bakker JA
; Van Offel J
; De Clerck L
; Huizinga TW
Clin Rheumatol
2017[Jul]; 36
(7
): 1487-1492
PMID28578492
show ga
This study compares the diagnostic performance of a second generation anti-cyclic
citrullinated peptide antibody (CCP2) with a third generation anti-CCP antibodies
assay (CCP3), as well as the combination of both tests. Serum samples of 127
patients were analyzed. IgG anti-CCP 2 and IgM rheumatoid factor were determined
by EliA? technique on a Phadia 250 instrument (Thermo Fisher Scientific),
anti-CCP3 by the Quanta Flash? anti-CCP3 IgG kit, BIO-FLASH Rapid Response
Chemiluminscence Analyzer (INOVA Diagnostics). Diagnostic performance was
compared using ROC-curves, sensitivity, specificity, likelihood ratios, and
predictive values. Logistic regressions were used to investigate whether using
both tests (anti-CCP2 and anti-CCP3) gives a better prediction of rheumatoid
arthritis. At the manufacturer's cut-offs sensitivity and specificity were 79.4
and 61.0% for CCP3 and 80.9 and 69.5% for CCP2. No significant differences could
be observed regarding the areas under the curve (AUC) of both ROC-curves. The
optimal cut-off point for CCP2 was 10.5 U/ml (sensitivity of 75.0% and
specificity of 80.0%) and 5.6 U/ml for CCP3 (sensitivity of 86.9% and specificity
of 61.0%). Binary logistic regressions indicated that the likelihood of having
rheumatoid arthritis (RA) is significantly higher when testing positive on both
CCP2 and CCP3 compared to CCP2 or CCP3 alone. In our cohort, comparable
performance was found between the two CCP assays. Positivity for both CCP2 and
CCP3 resulted in the most specific identification of RA patients. In patients
with joint complaints suspected of having RA and with a weakly positive CCP 2 (?7
and ?16 U/ml) CCP3 testing could be of additive value for diagnosing RA.
|*Enzyme-Linked Immunosorbent Assay
[MESH]
|*Luminescent Measurements
[MESH]
|Anti-Citrullinated Protein Antibodies/*blood
[MESH]