CCP Antibodies (Cyclic Citrullinated Peptide)

Notes

Rheumatoid arthritis (RA) is the most common form of inflammatory joint disease, but its diagnosis remains principally a clinical one. The major challenge lies in differentiating RA from the many other forms of arthritis that share several presenting symptoms but vary widely both in outcomes and therapeutic options. With a growing body of evidence indicating that joint destruction and functional decline in RA are improved by early, aggressive therapeutic intervention, the need for an unequivocal early diagnosis has become critical. NICE guidance for the management of rheumatoid athritis (RA) in adults recommends that the initial investigation carried out should be rheumatoid factor (RF). If RF is negative and it is still suspected that a patient has RA, a referral to a specialist should be made who can utilise Cyclic citrullinated peptide antibodies (CCP) as part of the clinical assessment. CCP antibodies have been shown to be highly specific for RA and appear early in the disease process when diagnosis is most difficult and intervention most effective. CCP antibody measurement is of value in confirming the diagnosis of RA in patients with atypical presentation, excluding a diagnosis of RA in patients where the RF is positive but the clinical features are equivocal and also as an indicator of early RA.