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Revista Habanera de Ciencias Médicas

On-line version ISSN 1729-519X


MARTINEZ TELLEZ, Goitybell et al. Diagnostic effectiveness of anti-citrullinated peptides antibodies of second and third generations for rheumatoid arthritis. Rev haban cienc méd [online]. 2018, vol.17, n.4, pp.540-554. ISSN 1729-519X.


Rheumatoid arthritis is an autoimmune disease characterized by the presence of antibodies against citrullinated peptides, which are one of the indicators for the diagnosis of a disease. The usefulness of different methods for the determination of these antibodies in the diagnosis of Cuban patients with rheumatoid arthritis is necessary to be established.


To establish the diagnostic effectiveness of the second (anti-CCP2) and third (anti-CCP3) generation assays for the determination these antibodies against citrullinated peptides in Cuban patients with rheumatoid arthritis.

Material and method:

101 patients with rheumatoid arthritis, 58 patients with other rheumatic and inflammatory diseases, and 43 healthy persons participated in the study. The diagnostic efficiency of rheumatoid factor (RF), anti-CCP2 and anti-CCP3 antibodies were determined using ELISA test, by calculating sensitivity, specificity, and positive and negative predictive values.


The anti-CCP2 assay showed a better balance of sensitivity (48.5 %) and specificity (98.0 %). The lower sensibility was observed for RF (40.3%) when the specificity was set at 98 %. Specificity increased to 100% when anti-CCP2 and RF assays were used. All autoantibodies showed association with C-reactive protein and correlation with erythrocyte sedimentation rate. Only anti-CCP2 antibodies showed no correlation with the DAS28 clinical indicator.


Anti-CCP2 antibodies are the ones of greater effectiveness in the diagnosis of Cuban patients with rheumatoid arthritis. RF identification allows to identify seronegative anti-CCP2 patients; therefore, the combination of both immunoassays leads to an improvement in the diagnostic effectiveness.

Keywords : Rheumatoid arthritis; cyclic citrullinated peptide; antibodies; anti-CCP2; anti-CCP3; diagnosis.

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