Autoimmune markers for the diagnosis of rheumatoid arthritis in primary care: primary care diagnostic technology update

  title={Autoimmune markers for the diagnosis of rheumatoid arthritis in primary care: primary care diagnostic technology update},
  author={Kamal Ram Mahtani and Anne Miller and Oliver Rivero-Arias and Carl J. Heneghan and Christopher P. Price and Matthew J. Thompson and Annette Pl{\"u}ddemann and Raashid A Luqmani},
  journal={The British Journal of General Practice},
  pages={553 - 554}
#### Clinical Question Should GPs use anti-citrullinated peptide antibody testing instead of rheumatoid factor for diagnosing rheumatoid arthritis? Early diagnosis and treatment of rheumatoid arthritis (RA) is important in preventing long-term damage and disability. RA should be suspected largely on the basis of clinical findings, such as persistent joint pain, swelling, and stiffness. Further investigations, particularly in primary care, may contribute to the diagnosis. Rheumatoid factor (RF… Expand
5 Citations
Pathogenic Role of Immune Cells in Rheumatoid Arthritis: Implications in Clinical Treatment and Biomarker Development
The pathogenic role of various immune cells and immunological molecules in RA is discussed and the importance of understanding the immune cells in treating RA is highlighted and in exploring novel biomarkers are highlighted. Expand
Precision medicine and management of rheumatoid arthritis.
The current status of PM in rheumatoid arthritis (RA) in the management areas of diagnosis, prognosis, selection of therapy, and decision to reduce therapy is discussed. Expand
MMP3 is a reliable marker for disease activity, radiological monitoring, disease outcome predictability, and therapeutic response in rheumatoid arthritis.
Monitoring serum levels of MMP3 reflects positively RA disease activity, joint and bone injury, and radiological erosion and predict disease outcome and drug responsiveness as summarized in several publications reporting outcomes on more than 8000 patients with RA. Expand
Influence of anti-cyclic citrullinated peptide on disease activity, structural severity, and bone loss in Moroccan women with rheumatoid arthritis
Anti-CCP antibodies are strongly predictive for the development of osteoporosis and erosions in Moroccan RA patients and not only have a valuable role in the disease prognosis prediction but also may be a relevant determinant of bone loss in RA. Expand
Evidence for models of diagnostic service provision in the community: literature mapping exercise and focused rapid reviews
Evidence from different settings that community- and primary care-based diagnostic services can reduce referrals to secondary care and allow more patients to be managed in primary care is found, but the quality of the research was generally poor. Expand


Anti‐CCP Antibody, a Marker for the Early Detection of Rheumatoid Arthritis
Testing for anti‐CCP autoantibodies is widely accepted as an indispensable tool for diagnosis and early treatment in the management of rheumatoid arthritis patients and is reported to predict the development of erosive RA. Expand
The serological diagnosis of rheumatoid arthritis: antibodies to citrullinated antigens.
The two ACPA assays now on the market are equally useful for the diagnosis of rheumatoid arthritis and the correlation between RA disease activity and stratification with ACPA has only been demonstrated to date through the detection of anti-MCV antibodies. Expand
Anti‐citrullinated peptide antibody: death of the rheumatoid factor?
A new clinical test for RA — the anti‐citrullinated peptide antibody (ACPA) test — is now widely available in Australia and due to its high specificity, a positive ACPA test result usually confirms a diagnosis of RA in a patient with undifferentiated inflammatory arthritis. Expand
Systematic Review: Accuracy of Anti–Citrullinated Peptide Antibodies for Diagnosing Rheumatoid Arthritis
Anti-CCP2 should be included in the work-up of patients with early symptoms of rheumatoid arthritis, and evidence was insufficient to ascertain whether the combination of anti- CCP2 and r heumatoid factor provides additional benefit over anti-CCp2 alone. Expand
Specific autoantibodies precede the symptoms of rheumatoid arthritis: a study of serial measurements in blood donors.
It is concluded that IgM-RF and anti-CCP testing with appropriately high specificity may assist in the early detection of RA in high-risk populations. Expand
Rheumatoid factor revisited
Recent insights into humoral autoimmunity in rheumatoid arthritis are summarized in the context of the generation of r heumatoid factors, including B cell activation via toll-like receptors and genetic predispositions that can trigger the induction of rhearatoid arthritis. Expand
The use of rheumatoid factors in clinical practice.
It is concluded that in this setting rheumatoid factor testing is of limited value and generates misleading information. Expand
The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide.
The anti-CCP ELISA might be very useful for diagnostic and therapeutic strategies in RA of recent onset and appears to be highly specific for RA, using prevalent RA and non-RA sera. Expand
Time to Treatment in Rheumatoid Arthritis: Factors Associated With Time to Treatment Initiation and Urgent Triage Assessment of General Practitioner Referrals
  • P. Robinson, W. Taylor
  • Medicine
  • Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
  • 2010
Assessment of factors associated with urgent triage for first specialist appointment and early disease modifying agents in rheumatic disease treatment found swollen joints and a raised C-reactive protein predicted GP request for urgency. Expand
Cost effectiveness of the determination of autoantibodies against cyclic citrullinated peptide in the early diagnosis of rheumatoid arthritis
Using aCCP in the diagnosis of RA in patients first diagnosed with undifferentiated arthritis and to estimate the incremental costs and quality-adjusted life years (QALYs) of using a CCP additionally to American College of Rheumatology (ACR) criteria is likely to be cost effective. Expand