Turkish Journal of Physical Medicine and Rehabilitation 2012 , Vol 58 , Num 4

The Relationship Between Serum Levels of Anti-Cyclic Citrullinated Peptide Antibodies and Disease Activity in Patients With Rheumatoid Arthritis

Alev Gürgan 1 ,Köksal Deveci 2 ,Hülya Deveci 3 ,Korhab Barış Bayram 4 ,Hikmet Koçyiğit 5
1 Atatürk Eğitim ve Araştırma Hastanesi Fizik Tedavi ve Rehabilitasyon Kliniği, İzmir
2 Cumhuriyet Üniversitesi Tıp Fakültesi, Biyokimya Anabilim Dalı, Sivas, Türkiye
3 Sivas Numune Hospital, Department of Physical Medicine and Rehabilitation, Sivas, Turkey
4 Ataturk Education and Research Hospital, Department of Physical Medicine and Rehabilitation, İzmir, Turkey
5 İzmir Atatürk Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, İzmir, Türkiye
DOI : 10.4274/tftr.16769

Objective: Although there is an opinion that anti-cyclic citrullinated peptide antibody (anti-CCP) is a reliable diagnostic and prognostic indicator in rheumatoid arthritis (RA), its association with disease activity and severity is uncertain. This study has been planned to determine the relationship between anti-CCP antibody levels and the disease activity in patients with RA.


Materials and Methods: A total of 48 patients, who have been diagnosed with RA, were included in the study. After physical examination, all patients were evaluated with clinical and laboratory parameters. The clinical symptoms were assessed using visual analog scale (VAS), disease activity score (DAS-28) and Health Assessment Questionnaire (HAQ). Rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), thrombocyte, leukocyte, hemoglobin and anti-CCP levels were investigated.


Results: The anti-CCP results were positive in 33 patients (68.7%) and negative in 15 patients (31.3%). Anti-CCP was positive in 30.4% of RFnegative patients. A significant difference was observed in average RF levels when the anti-CCP positive and negative patients were compared, however, there was no significance between other parameters. In logistic regression analysis of multiple parameters, higher DAS-28 scores and RF positivity were associated with 5.95 and 5.4 times greater risk of being anti-CCP positive, respectively.


Conclusion: Anti-CCP can be used in the diagnosis of patients with seronegative RA and also may be useful for reflecting disease activity.

Keywords : Rheumatoid arthritis; anti-CCP antibodies; disease activity; rheumatoid factor