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  • Review: anti–cyclic citrullinated peptide antibody is a more specific test for rheumatoid arthritis than rheumatoid factor

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Diagnosis
Review: anti–cyclic citrullinated peptide antibody is a more specific test for rheumatoid arthritis than rheumatoid factor

https://doi.org/10.1136/ebm.12.6.183

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    Are rheumatoid factor (RF) and anti–cyclic citrullinated peptide antibody (anti-CCP) accurate tests for rheumatoid arthritis (RA)?

    Nishimura K, Sugiyama D, Kogata Y, et al. Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis. Ann Intern Med 2007;146:797–808.

    Clinical impact ratings Rheumatology ★★★★★★★ Internal medicine ★★★★★★⋆

    METHODS

    Embedded ImageData sources:

    Medline (to September 2006) and reference lists.

    Embedded ImageStudy selection and assessment:

    studies published after 1987 that evaluated the accuracy of RF or anti-CCP for diagnosis of RA in ⩾10 participants. 50 studies of RF (n = 15 286, median age 53 y, 68% women) and 37 studies of anti-CCP (n = 14 949, median age 57 y, 59% women) met the selection criteria.

    Embedded ImageOutcomes:

    pooled sensitivity, specificity, and positive and negative likelihood ratios (LRs). The reference standard for RA was the 1987 revised American College of Rheumatology criteria.

    MAIN RESULTS

    Anti-CCP and IgM RF had similar …

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    Footnotes

    • Sources of funding: Ministry of Education, Culture, Sports, Science, and Technology, Japan and Ministry of Health, Labour, and Welfare, Japan.