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A comparison of anti-cyclic citrullinated peptides (CCP3 and CCP3.1) autoantibody tests in rheumatoid arthritis

Authors :
Heather A. Nelson
Dipanwita Banerjee
Camille L. Novis
Kevin D. Deane
Marie L. Feser
Vijayalakshmi Nandakumar
Source :
Practical Laboratory Medicine, Vol 41, Iss , Pp e00420- (2024)
Publication Year :
2024
Publisher :
Elsevier, 2024.

Abstract

Background: Anti-citrullinated protein antibodies (ACPA) are a specific serological biomarker used in the diagnosis of rheumatoid arthritis (RA). In clinical practice ACPA can be identified using immunoassays targeting synthetic cyclic citrullinated peptides (CCP). The 3rd generation anti-CCP IgG antibody (CCP3) offers improved sensitivity compared to the earlier versions. Recently, CCP3.1, capable of detecting both IgG and IgA antibodies, was introduced to enhance sensitivity, especially in patients with early RA. Methods: We assessed serum CCP3.1 against CCP3 in 331 subjects undergoing RA panel serology, comprising 136 patients with RA and 195 patients without RA. Sera were tested for anti-CCP IgG (CCP3) and anti-CCP IgG/IgA (CCP3.1) antibodies. Clinical performance of these tests was compared at manufacturer-suggested cutoffs. A separate set of 81 patients with a diagnosis of RA by 2010 criteria and whose samples were obtained from within 1-year of RA diagnosis was similarly assessed to evaluate assay performance in an independent clinical RA cohort. Results: Overall diagnostic accuracy was similar; CCP3 had an area under the curve (AUC) of 0.88, CCP3.1 had an AUC of 0.89. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CCP3 were 79 %, 91 %, 86 %, and 86 %, respectively. For CCP3.1, sensitivity was 78 %, specificity 93 %, PPV 89 %, NPV 86 %. Both assays demonstrated excellent agreement; positive percent agreement of 94 % and negative percent agreement of 99 %. Conclusion: Our findings indicate comparable diagnostic accuracy between CCP3 and CCP3.1 assays in these clinical cohorts.

Details

Language :
English
ISSN :
23525517
Volume :
41
Issue :
e00420-
Database :
Directory of Open Access Journals
Journal :
Practical Laboratory Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.981c66e252424a77886d4d3bc78fbc57
Document Type :
article
Full Text :
https://doi.org/10.1016/j.plabm.2024.e00420