Association between Anti-Citrullinated Peptide Antibodies (ACPA) Levels and Disease Severity in Patients with Rheumatoid Arthritis

Poopak  Mohaghegh; Mohammad Sadegh  Ghasempuor; Azizallah  Dehghan

doi:10.18502/jabs.v16i1.20124

Poopak Mohaghegh Department of Internal Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
Mohammad Sadegh Ghasempuor Department of Internal Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
Azizallah Dehghan Department of Epidemiology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran

DOI: https://doi.org/10.18502/jabs.v16i1.20124

Keywords: Anti-CCP, Rheumatoid Arthritis, DAS28-CRP, Disease Activity, Case- Control Study

Abstract

Background & Objectives: This case–control study was conducted to assess the diagnostic accuracy of serum anti-cyclic citrullinated peptide (anti-CCP) antibodies in rheumatoid arthritis (RA) and to determine their correlation with disease activity, as measured by the Disease Activity Score in 28 joints using C-reactive protein (DAS28- CRP).

Materials & Methods: A total of 70 patients with RA (85.7% female; mean age = 55.7 ± 11.73 years) and 70 age- and sex-matched healthy controls were included. Serum anti-CCP levels were measured using an enzyme-linked immunosorbent assay (ELISA), and disease activity was evaluated based on DAS28-CRP scores. Pearson’s correlation coefficient was applied to assess the relationship between anti-CCP levels and RA disease activity.

Results: Anti-CCP exhibited a sensitivity of 61.4% and a specificity of 98.6% for the diagnosis of RA. The mean serum anti-CCP concentration was significantly elevated in RA patients (220.2 ± 27.5 IU/mL) compared with controls (1.57 ± 0.52 IU/mL; p < 0.001). However, no statistically significant correlation was observed between anti-CCP levels and disease activity as determined by DAS28-CRP (p = 0.4).

Conclusion: Anti-CCP is a highly specific serological biomarker for the diagnosis of RA but does not demonstrate a significant association with disease activity as measured by DAS28-CRP. Further large-scale, longitudinal investigations are warranted to elucidate its potential role in predicting long-term joint destruction and disease progression.