What is the significance of anti-cyclic citrullinated peptide (anti-CCP) antibody, Immunoglobulin G (IgG)/Immunoglobulin A (IgA)?

From the Guidelines

The LOINC code for Anti-CCP Ab, IgG/IgA is 53028-7, which is crucial for accurate documentation and billing of the laboratory test that measures both IgG and IgA antibodies against cyclic citrullinated peptides in serum. This code is essential for identifying the test that detects anti-CCP antibodies, important diagnostic markers for rheumatoid arthritis (RA) that can be detected years before clinical symptoms appear 1. The test has high specificity (95-98%) for RA, making it valuable for early diagnosis, and positive results, especially at high titers, are associated with more aggressive disease and increased risk of joint damage 1. Some patients may be positive for one marker but not the other, so this test is often ordered alongside rheumatoid factor (RF) to improve diagnostic accuracy 1. Using the correct LOINC code ensures proper documentation, billing, and interoperability between different healthcare information systems. Key points to consider include:

• High specificity of the anti-CCP test for RA diagnosis
• Importance of early detection for preventing joint damage
• Use of the correct LOINC code for accurate documentation and billing
• The test is often used in conjunction with RF for improved diagnostic accuracy
• The presence of anti-CCP antibodies can indicate a more aggressive disease course.

From the Research

Anti-CCP Antibody Testing

• Anti-CCP antibody testing is a useful diagnostic tool for rheumatoid arthritis (RA) due to its high specificity and ability to identify patients with severe disease 2.
• The sensitivity of anti-CCP antibody testing is lower, and a negative result does not exclude the disease 2.
• Anti-CCP antibodies are more specific than rheumatoid factor for detecting RA 2, 3.

Comparison of Anti-CCP Antibody Assays

• Different anti-CCP antibody assays have varying diagnostic performances, with the anti-CCP3 assay showing higher sensitivity than anti-CCP2 assays 4.
• The agreement between different anti-CCP antibody assays ranges from 86.3% to 95.2% 4.
• Automated workstations provide a valuable alternative to ELISA for diagnosing RA, but differences in diagnostic performances exist between assays 4.

Diagnostic Utility of Anti-CCP Antibodies

• Anti-CCP antibodies have better diagnostic performance than other markers, such as matrix metalloproteinase-3, rheumatoid factor, erythrocyte sedimentation rate, and C-reactive protein, in patients with erosive RA 5.
• Elevated anti-CCP antibody titers are associated with erosive disease and have a higher positive predictive value than other markers 5.
• The presence of anti-CCP antibodies is correlated with rheumatoid factor, particularly in non-erosive patients 5.

Clinical Diagnosis of Rheumatoid Arthritis

• The combination of rheumatoid factor and anti-CCP antibody testing is beneficial for confirming a diagnosis of RA 6, 3.
• Anti-CCP antibody testing should be used concomitantly with other diagnostic tools, such as rheumatoid factor and inflammatory markers, to diagnose RA 6, 3.