THE PROGNOSTIC VALUE OF ANTI CITRULLINATED PROTEIN ANTIBODY TEST IN RHEUMATOID ARTHRITIS

Background: Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. About 1% of the world's population is afflicted by rheumatoid arthritis, women three times more often than men. Onset is most frequent between the ages of 40 and 50, but any age  group can be affected.
Aim of Work : To study the value of Anti cyclic citrullinated protein (Anti-CCP) test as a predictor of disease course, disability, prognosis and response to treatment in Rheumatoid arthritis patients of a specific age group with regard to history, clinical and radiological findings. The results for Anti-CCP will be compared to Rheumatoid factor test.  Patients: 80 female cases were collected from rheumatology outpatient clinics, with disease duration of  3- 5 years and age range from 35 to 40 years Methods: All cases underwent thorough history taking, clinical examination, radiological and laboratory assessment as well as disability and health assessment scoring. Each patient will undergo a quantitative test of Anti cyclic citrullinated protein (Anti-CCP) and Rheumatoid factor. Results : Our study showed  that there was high significant relation between positive and negative RF and Anti-CCP titres. (p=0.0000) for the patients in the studied group. There was a high significant correlation between Anti-CCP and RF titres (r=0.81, p<0.05)
Also there was a significant correlation between Anti-CCP and ACR disability class. In addition, there was a positive but not significant correlation between Anti-CCP and STLW score. (Clinical findings score- Swelling, Tenderness, limitation of movement, Warmth) and with VAS (Visual analogue scale) Conclusion: Our study found that Anti-CCP has a reasonably good prognostic value, especially as regards disability and functional status prediction. It also showed that Anti-CCP is very comparable to Rheumatoid factor when comparing prognostic values. It is only slightly more indicative in terms of clinical, radiological and health assesment.