Value of Anti-Cyclic Citrullinated Peptide and Rheumatoid Factor Antibodies in relation to Rheumatoid Arthritis: Association with Osteoporosis

Objective: To study the role of anti-Cyclic Citrullinated Peptide antibody (anti-CCP) and Rheumatoid Factor (RF) in Rheumatoid Arthritis (RA) and to evaluate their relation to the development of erosion, osteoporosis, disease activity, disease severity and functional disability. Methods: Anti-CCP, RF and CRP assays were done for 128 patients diagnosed with RA, in addition to 151 healthy and 30 osteoporotic postmenopausal female controls. Assessment measures for disease Activity, disease severity, erosions, osteoporosis and functional disability were done for RA patients. Result: The titer and seropositivity of the studied serologic markers (Anti-CCP and RF) have significant association with RA. Osteoporosis complicating RA is positively associated with seropositivity of anti-CCP. While, the seropositivity of anti-CCP antibody is significantly associated with more severe and active disease, the seropositivity of RF is positively associated only with disease severity. The high positive anti-CCP or high positive RF is positively associated with increased disease severity or activity and presence of osteoporosis. Higher titer of anti-CCP is a significant risk to the development of erosion and OP in RA patients either in crude or adjusted models. Conclusion: Due to its higher specificity, anti-CCP is useful serologic marker for diagnosis of RA as compared to RF and can predict disease activity. Anti-CCP antibodies identify a subset of patients who are more likely to accrue more joint damage, more severe disease course and to develop osteoporosis.