Table 5

Studies evaluating the significance of anti-CCP titer in patients with undifferentiated arthritis (UA)

Author [ref]

Patients, n

UA

UA duration

FU

Anti-CCP

CCP+ baseline

UA outcome

Anti-CCP titer significance

Kudo-Tanaka [27]

146

≥ 2 Sj

≤ 2 yr

1 yr

≥ 5 U/ml no serial assay

17%

12% RA 37% non-RA 41% UA

164 ± 136 RA vs 55 ± 72 non-RA/UA P = 0.017

Guzian [18]

253 (83% RA baseline)

≥ 3 Sj

≤ 1 yr

30 mo.

≥ 20 U/ml serial assay (0.30 mo.)

38%

17% RA

No correlation low-high CCP/DAS28, HAQ, erosions

Ursum [31]

545

≥ 2 Sj

≤ 3 yr

2 yr

≥ 5 U/ml serial assay (0.1 yr)

56%

63% RA baseline or at 1 yr

No correlation CCP change/DAS28, HAQ, SHS

Emad [28]

69

≥ 1 Sj

≤ 1 yr

1 yr

≥ 2.9 U/ml no serial assay

59%

26% RA 6% PsA 41% UA 26% remission

Correlation CCP titer/Sj, Tj, ESR, erosions

Bos [30]

147

arthralgia

12 (7-36) mo. median

28 (19-39) mo. median

≥ 5 U/ml no serial assay

34%

7% RA 13% ≥ 4Sj 80% no-arthritis

Median 141 arthritis vs 31 U/ml non-arthritis HR = 1.7

Mjaavatten [29]

376 (19% RA baseline)

≥ 1 Sj

≤ 16 wk

1 yr

≥ 25 U/ml no serial assay

16%

46% persistent 54% self-limiting

25-100 OR 4.4 101-250 OR = 9.4 > 250 OR = 14 for persistence

Burr [21]

640 (49% RA baseline)

≥ 2 Sj

≥ 4 wk

5 yr

≥ 5 U/ml serial assay (0.5 yr)

30%

72% RA 28% non-RA

Median 1.6 U/ml RA vs 0.8 U/ml non-RA

Present study

192

≥ 1 Sj

≤ 12 wk

2 yr

serial assay (0.6,12,18,24 mo.)

42%

37% RA 30% UA 17% self-limiting 16% non-RA RD

Correlation titer/time to RA onset and RA development

RA, rheumatoid arthritis; FU, follow up; Sj, swollen joint; CCP, cyclic citrullinated peptide; Tj, tender joint; DAS28, disease activity score; HAQ, health assessment questionnaire; PsA: psoriatic arthritis; RD, rheumatic disease; SHS, Sharp Heijde Score; ESR, erythrocyte sedimentation rate; HR, hazard ratio; OR, odds ratio.

Bizzaro et al. Arthritis Research & Therapy 2013 15:R16   doi:10.1186/ar4148