Antibodies to citrullinated human fibrinogen (ACF) have diagnostic and prognostic value in early arthritis
Open Access
- 1 August 2005
- journal article
- other
- Published by Elsevier in Annals of the Rheumatic Diseases
- Vol. 64 (8) , 1199-1204
- https://doi.org/10.1136/ard.2004.029389
Abstract
Background: The anti-cyclic citrullinated peptide (CCP) test has a high sensitivity and specificity for rheumatoid arthritis, although CCP is not the physiological target of the autoantibodies. Citrullinated fibrin is abundant in inflamed synovium Objective: To assess the diagnostic and prognostic value of antibodies against citrullinated fibrinogen (ACF), a soluble precursor of fibrin, in comparison with IgM-rheumatoid factor (IgM-RF) and the second generation anti-CCP test. Methods: In 379 patients with early arthritis (258 rheumatoid and 121 undifferentiated), the sensitivity, specificity, and positive predictive value of ACF, anti-CCP, and IgM-RF for diagnosing rheumatoid arthritis were calculated. Multivariate logistic regression analysis was used to assess the diagnostic and prognostic value (radiographic progression after two years) of the tests. Results: The sensitivities of the ACF, anti-CCP, and IgM-RF tests were 55.8%, 57.8%, and 44.6%, with specificities of 92.6%, 94.2%, and 96.7%, respectively. Approximately 30% of the IgM-RF negative patients were positive for ACF or anti-CCP or both. The ACF and anti-CCP test had a high agreement in early arthritis (κ = 0.84). Of all baseline characteristics, the ACF test and the anti-CCP test were the best predictors for diagnosing rheumatoid arthritis at one year (odds ratio (OR) = 10.3 and 10.6, respectively) and for radiographic progression after two years (OR = 12.1 and 14.8). Conclusions: ACF is as sensitive as anti-CCP and more sensitive than IgM-RF in diagnosing rheumatoid arthritis in early arthritis. The ACF test is also a good predictor of radiographic progression, with a performance similar to the anti-CCP test. The ACF test and the anti-CCP test are especially valuable in IgM-RF negative arthritis.Keywords
This publication has 34 references indexed in Scilit:
- Prediction of radiological outcome in early rheumatoid arthritis in clinical practice: role of antibodies to citrullinated peptides (anti-CCP)Annals of the Rheumatic Diseases, 2004
- Autoantibodies to cyclic citrullinated peptides predict progression to rheumatoid arthritis in patients with undifferentiated arthritis: A prospective cohort studyArthritis & Rheumatism, 2004
- Autoantibodies can be prognostic markers of an erosive disease in early rheumatoid arthritisAnnals of the Rheumatic Diseases, 2003
- Epitope spreading in systemic lupus erythematosus: Identification of triggering peptide sequencesArthritis & Rheumatism, 2002
- Determination of the minimal clinically important difference in rheumatoid arthritis joint damage of the Sharp/van der Heijde and Larsen/Scott scoring methods by clinical experts and comparison with the smallest detectable differenceArthritis & Rheumatism, 2002
- Citrulline is an essential constituent of antigenic determinants recognized by rheumatoid arthritis-specific autoantibodies.Journal of Clinical Investigation, 1998
- Modified disease activity scores that include twenty-eight-joint counts development and validation in a prospective longitudinal study of patients with rheumatoid arthritisArthritis & Rheumatism, 1995
- Biannual Radiographic Assessments of Hands and Feet in a Three‐Year Prospective Followup of Patients with Early Rheumatoid ArthritisArthritis & Rheumatism, 1992
- The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritisArthritis & Rheumatism, 1988
- Measurement of patient outcome in arthritisArthritis & Rheumatism, 1980