DIAGNOSTIC AND PROGNOSTIC VALUE OF ANTI-CYCLIC CITRULLINATED PEPTIDE AND RHEUMATOID FACTOR IN RHEUMATOID ARTHRITIS PATIENTS.

OBJECTIVES

This study aimed to assess the diagnostic and prognostic value of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies in rheumatoid arthritis (RA) patients, focusing on early diagnosis and disease activity.

METHODS

Dr. Mohammed Ali Saad Medical Center and Doctors Hospital in Port Sudan, red sea state in Sudan were the sites of an analytical case-control study was conducted, including 166 RA patients, 68 early RA patients, and 166 healthy controls. RF, anti-CCP, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured. Statistical analyses included chi-square, Kruskal-Wallis, and receiver operating characteristic (ROC) curve studies.

RESULTS

RF and anti-CCP antibody levels were higher in established RA patients than in early RA patients and healthy controls (p < 0.001). Anti-CCP demonstrated superior specificity (98%) compared to RF (79% specificity) for RA diagnosis. In established RA, anti-CCP showed higher sensitivity (79%) than RF (67%). However, the majority of early RA patients (54.5%) tested negative for both markers, indicating that inflammatory markers such as CRP and ESR may be more useful than autoantibodies for early RA detection. The combination of both tests enhanced diagnostic sensitivity in established RA.

CONCLUSION

It was discovered that anti-CCP antibodies were a very specific indicator of RA, especially when the disease was progressed. Improved diagnostic accuracy is achieved when RF and anti-CCP testing are combined, with anti-CCP testing showing greater sensitivity for early RA identification. This study emphasizes how useful both markers are in clinical practice for RA patient prognosis, disease activity evaluation, and early diagnosis.