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 Association between Anti-Citrullinated Peptide Antibodies (ACPA) Levels and Disease Severity in Patients with Rheumatoid Arthritis
Poopak Mohaghegh, Mohammad Sadegh Ghasempuor, Azizallah Dehghan,
Volume 16, Issue 1 (1-2026)
Abstract
Background & Objectives: This case–control study was conducted to assess the diagnostic accuracy of serum anti-cyclic citrullinated peptide (anti-CCP) antibodies in rheumatoid arthritis (RA) and to determine their correlation with disease activity, as measured by the Disease Activity Score in 28 joints using C-reactive protein (DAS28-CRP).
Materials & Methods: A total of 70 patients with RA (85.7% female; mean age = 55.7 ± 11.73 years) and 70 age- and sex-matched healthy controls were included. Serum anti-CCP levels were measured using an enzyme-linked immunosorbent assay (ELISA), and disease activity was evaluated based on DAS28-CRP scores. Pearson’s correlation coefficient was applied to assess the relationship between anti-CCP levels and RA disease activity.
Results: Anti-CCP exhibited a sensitivity of 61.4% and a specificity of 98.6% for the diagnosis of RA. The mean serum anti-CCP concentration was significantly elevated in RA patients (220.2 ± 27.5 IU/mL) compared with controls (1.57 ± 0.52 IU/mL; p < 0.001). However, no statistically significant correlation was observed between anti-CCP levels and disease activity as determined by DAS28-CRP (p = 0.4).
Conclusion: Anti-CCP is a highly specific serological biomarker for the diagnosis of RA but does not demonstrate a significant association with disease activity as measured by DAS28-CRP. Further large-scale, longitudinal investigations are warranted to elucidate its potential role in predicting long-term joint destruction and disease progression.
 

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