Prevelance of Anti CCP Antibodies in Patients with Rheumatoid Arthritis” – One Year Cross sectional study at KLES Dr. Prabhakar Kore Hospital and MRC, Belgaum

Abstract

Background and objectives ABSTRACT Anti-cyclic-citrullinated-peptide antibodies (anti-CCPs) hold promise for earlier and more accurate diagnosis of rheumatic arthritic (RA) disease, improved prognostic information, and have been implicated in RA pathogenesis. The present study was undertaken to find prevalence of anti CCP antibodies in patients with RA, to assess the positivity of anti CCP antibody in subsets of RA factor positive and negative patients and to correlate anti CCP positivity with severity of rheumatoid arthritis. Methodology The present one year cross sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum during the period of January 2010 to December 2010 on 100 patients with history, suggestive of RA and fulfilling ACR Criteria 1987. The severity of the disease was calculated using Disease Activity Score 28 (DAS 28) score. Results In the present study females outnumbered male (77% vs 23%) with male to female ratio of 1:3.34. The mean age was 44.74 ± 11.62 years. RF was positive in 77% and negative in 23% of all patients and anti CCP was found to be positive in only 43 % and negative in 57% of the patients. 94% of the patients were having severe disease while 6% had moderate disease. The sensitivity of CCP in measuring RF was 55.7%. The specificity of CCP in measuring RF is 35.9%, that IX is among those who were RF negative, 35.9% were also CCP negative. In RA positive subset of patients anti-CCP positive titres had significantly positive correlation with severity of RA disease. Interpretation and conclusion Anti-CCP titres were found to have a positive correlation with the severity of the disease. Anti-CCP should be used along with RF in patients with clinical suspicion of RA.