Are assays for anti-citrullinated protein antibodies (ACPA) used to diagnose rheumatoid arthritis (RA)?

Updated: Feb 07, 2020
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
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Assays for anti-citrullinated protein antibody (ACPA; often tested as anti-CCP) are now being used clinically for diagnosing RA. ACPA-positive and ACPA-negative RA may be 2 distinct disease subsets, with different underlying pathogeneses and risks for developing RA. [42, 43] ACPA-positive patients may have a more erosive RA disease course than ACPA-negative patients. [44] However, a 2011 study suggests that reassessment of ACPA or IgM RF during the first year after onset of arthritis does not provide significant additional information. [45]

The sensitivity of anti-MCV assays has been reported to be comparable to that of ACPA [46] ; however, other studies have found the specificity of anti-MCV to be slightly lower than that of ACPA. [47, 48] Anti-MCV and anti-CCP levels may correlate with disease activity. [46, 49]

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