Evaluation of anti-ccp for early diagnosis and assessment of disease severity in rheumatoid arthritis patients

Rheumatoid Arthritis is a severe, progressive, systemic inflammatory disease of unknown etiology characterized by chronic and erosive polyarthritis by abnormal growth of synovial tissue or pannus and causes irreversible joint disability. The diagnosis of RA, particularly early in the course of disease is empirical and imprecise. A study was carried out on 100 patients who were presented with polyarthritis within one year of presentation. The patients were divided into two groups. 50 patients who fulfilled the ARA criteria for RA were included in Group A. Again 50 patients who had polyarthritis but not fulfilled the ARA criteria were included in Group B. The patients were evaluated clinically and investigated. The anti CCP antibody was analyzed in relation with its sensitivity and specificity and also with different activity markers of RA. It was found that the specificity and sensitivity of Anti CCP was 86% and 64% respectively in early presentation of RA. The activity marker of RA were significantly correlated (DAS 28 score r=0.912; CRP, r=0.323; and VAS, r=0.382) with the increasing titre of Anti CCP (p<0.01). ESR were not correlated with the increasing titre of anti-CCP levels (r=0.016, p>0.05). Anti – CCP has high specificity and moderate sensitivity in the early presentation of RA. So it can be used as a reliable serological marker for early diagnosis of RA. The increasing titre also significantly correlated with increasing disease activity markers. So anti-CCP can be used as a reliable serological marker for early diagnosis and assessment of disease severity.