Rheumatoid Arthritis Diagnosed by Anti-CCP Assay

A highly specific assay for the diagnosis of rheumatoid arthritis (RA) also predicts the eventual development of RA when found in undifferentiated arthritis. The fully automated, second generation test determines human immunoglobulin G (IgG) autoantibodies to cyclic citrullinated peptides (anti-CCP) in serum or plasma.

The anti-CCP assay is more precise than tests for other RA markers such as rheumatoid factor (RF) and C-reactive protein (CRP). The assay uses a small sample volume (15µL) and produces reliable results in just 18 minutes. The February 2009 National Institute for Health and Clinical Excellence (NICE; London, UK) guideline recommends testing for anti-CCP, in the management of patients with suspected RA where tests for RF are negative.

RA is diagnosed according to clinical manifestations and laboratory investigations. Common laboratory tests for RA include assays for RF, C-reactive protein (CRP) and antibodies to cyclic citrullinated protein (anti-CCP). RF is nonspecific for RA, because it may be present in healthy elderly persons or patients with other autoimmune or infectious diseases; CRP is a general inflammation marker whereas anti-CCP is highly specific for RA.

Rheumatoid arthritis is a chronic, inflammatory autoimmune disorder that affects approximately 1% of the population in the UK and Ireland. The condition is often severely disabling, causing a loss of mobility due to pain and joint destruction.

The new test for RA is called the Elecsys Anti-CCP assay and is available on the Roche Diagnostics (Burgess Hill, UK) modular analytics, cobas 6000 and cobas 4000 systems. Clinical laboratories can consolidate testing for a number of different autoimmune tests including RF and CRP on a single serum work area (SWA) platform.

With 183 different assays, Roche offers a large menu of tests (including its immunology test portfolios) for an automated SWA, allowing laboratories to perform the assays in-house on a single platform.

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