If you had a way of knowing your rheumatoid arthritis would affect function sooner rather than later, you could opt for more aggressive treatment now, with hopes of preventing future decline. Tests for rheumatoid arthritis couldn’t previously supply this information, but now there is a way to peek into the future.
When tissue injury occurs due to rheumatoid arthritis, chances are good that antibodies against citrullinated proteins will be found in the damaged area. Researchers recently discovered the role of these antibodies in people with RA and developed a synthetic version of the proteins, called “cyclic” citrullinated proteins (CCP), for use in diagnostic testing. The result was the anti-CCP antibody test, which in most cases helps identify people who have RA. A positive test means it is 90 to 95 percent likely the person has rheumatoid arthritis.
The test has proved useful for diagnosing RA early, when other markers, such as rheumatoid factor (RF), fail to do so in some people. Having an earlier diagnosis means earlier treatment. Now, the test has been made even more sensitive and may help predict how a person recently diagnosed with rheumatoid arthritis will function a few years down the road.
Researchers from the United Kingdom studied the usefulness of this more sensitive arthritis prognosis test in 303 people with either RA or connective tissue disease. Participants had symptoms for less than two years at the beginning of the study and were followed to see how their disease progressed in a two-year period.
Levels of RA markers, such as C-reactive protein, RF and anti-CCP antibodies, were measured at the start of the study. Function was assessed and X-rays were taken to determine the extent of joint damage at the beginning of the study and again at 12 and 24 months.
In people who were RF-negative, having an anti-CCP antibody value greater than 100, as measured by the more sensitive test, correlated with poor function at 24 months.
If you’ve just been diagnosed with rheumatoid arthritis, be sure to talk to your rheumatologist about the second-generation anti-CCP test, called the anti-CCP(2) test, which is widely available, as well as all your treatment options.