CLINICAL EFFICACY OF ANTI-CCP AND RHEUMATOID FACTOR IN DIAGNOSIS OF RHEUMATOID ARTHRITIS
Objective: To determine the clinical efficacy of Rheumatoid factor (RF) and anti-CCP for diagnosis of rheumatoid arthritis in patients with symptoms of joint pains.
Material and Methods: The serum anti-CCP and RF levels were performed in pathology department from October 2019 to September 2020. Patients who visited the Rheumatology Clinic of Medicine department of Bahawal Victoria Hospital with muscular and joint pains. The quantitative parameters (RF and anti CCP) were calculated by median and interquartile range (IQR). The sensitivities, specificities, positive predictive and negative predictive levels of both parameters were performed. Receiver operator curves (ROC) analysis was done. The area under curves were calculated for RF and anti-CCP.
Results: During this study duration, 180 patients with muscular and joint pains were investigated for RF, ESR CRP and anti-CCP tests. The small joints of the hands were mainly affected. The pain and swelling of joints with morning stiffness were chief presenting symptoms of patients. The sensitivity, specificity, PPV and NPV of serum anti-CCP were 92%, 87%, 89% and 92% while that of RF were 80%, 66%, 73% and 62% respectively. The AUC of 0.89 and 0.79 were measured on ROC analysis for anti-CCP and RF.
Conclusion: This study showed that anti-CCP is more sensitive and specific serological marker for diagnosis of RA.
Key Words: Clinical efficacy, Anti CCP, RF, Rheumatoid arthritis.