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 5,967 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Rheumatoid factor(RF) is one item in the classification criteria for rheumatoid arthritis(RA), with a tolerable sensitivity of 69.3% for RA but low specificity against other rheumatic diseases(76.4%). Anti-agalactosyl IgG antibody(CARF) showed a slightly higher sensitivity(72.0%) but the specificity was even lower(67.9%). Anti-cyclic citrullinated peptide antibody(anti-CCP), a new diagnostic test for RA, demonstrated higher sensitivity(76.0%) and specificity(91.5%), and the ROC analysis revealed the marked superiority of anti-CCP to other markers(i.e. RF, CARF, and IgG-RF). Matrix metalloproteinase-3 (MMP-3) showed a significantly positive correlation with CRP, suggesting it might be more useful for evaluation of RA activity and prediction of the prognosis of joint destruction. On the contrary, two combination assays, "MMP-3 or CARF" and "MMP-3 or anti-CCP", showed the highest sensitivity(86.7%) for RA. Similarly, in early RA the sensitivities of CARF, MMP-3 and anti-CCP were lower than in RA(66.7%, 66.7% and 58.3%, respectively), but the sensitivities of combination assays "MMP-3 or CARF" and "MMP-3 or anti-CCP" were 91.7% and 83.3%, respectively. Thus, we concluded that these combination assays are useful in the diagnosis of RA and detection of early RA.
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PMID:[New diagnostic tests for rheumatoid arthritis]. 1465 4

To prevent joint destruction, it is important to diagnose RA early and to speculate the prognosis. Several new laboratory tests have been developed for this purpose. In addition to rheumatoid factor (RF), IgG-RF, anti-agalactosyl IgG antibodies (CARF), and matrix metalloproteinase 3 (MMP-3) have become available as diagnostic tests for RA. Among them, anti-cyclic citrullinated peptide antibodies (anti-CCP antibodies) have the sensitivity and specificity of 81.0% and 92.4%, respectively, which are superior to other laboratory tests by ROC analysis. Moreover, the specificity of anti-CCP antibodies to diagnose early RA was much higher than that of RF, although the sensitivity of CARF was slightly high compared with that of RF. In contrast, MMP-3 is thought to be an evaluative test for the activity of RA because a significant correlation was found between MMP-3 and CRP, but MMP-3 has a possibility as a prognostic test to know the joint damage of RA. We have shown that the progression of joint damage (Sharp score) was faster in MMP-3-positive patients than negative patients. Anti-CCP antibodies was also reported to associate with the progression of joint damage and may be used also as a prognostic test. We next examined how efficiently was the diagnosis of RA made by combining these laboratory tests. Although anti-CCP antibodies are highly specific to RA, the specificity of RF was not so high but became up to 92% when combined with MMP-3. In order to diagnose RA efficiently, we may firstly examine RF, next MMP-3 if RF is positive, and anti-CCP antibodies if RF is negative.
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PMID:[Topics on immunological tests for rheumatoid arthritis]. 1562

Rheumatoid factor (RF) has been commonly used as a marker of rheumatoid arthritis (RA). RF can be detected in 60-80% of RA patients, but the specificity is low against other rheumatic diseases patients. We evaluated the diagnostic accuracy of anti-cyclic citrullinated peptide antibody (anti-CCP), a new diagnostic test for RA. Anti-CCP demonstrated higher sensitivity (81.0%) and specificity (92.4%). By the receiver operating characteristic (ROC) curve analysis, anti-CCP was superior to other markers (ie. RF, CARF, IgG-RF, and MMP-3). In early RA patients (RA patients who had had disease symptoms for < 2 years), sensitivity was 68.8%. Positivities of anti-CCP in RA patients became higher as the advance of stage defined by the Steinbrocker classification. We concluded that anti-CCP is a very valuable tool for the diagnosis of RA. Moreover, anti-CCP is a useful for finding RA of recent onset.
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PMID:[Usefulness of anti-cyclic citrullinated peptide antibodies (anti-CCP) for the diagnosis of rheumatoid arthritis]. 1567 42

To prevent joint destruction, it is important to diagnose RA early and to consider the prognosis. For this purpose, several new laboratory tests, such as IgG-RF, anti-agalactosyl IgG antibodies (CARF), and matrix metalloproteinase-3 (MMP-3), have become available for diagnosing RA. RF has a tolerable sensitivity of 68.5% for RA, but low specificity of 77.1%, and also 76.0% for patients with other rheumatic diseases and chronic inflammatory disease, respectively. CARF showed slightly higher sensitivity but low specificity for other rheumatic diseases and chronic inflammatory patients. In contrast, anti-cyclic citrullinated peptide antibody (anti-CCP), a new diagnostic test for RA, demonstrated significantly high specificity for other rheumatic diseases, and also for chronic inflammatory disease patients. Anti-CCP was superior to other laboratory tests by ROC analysis. Moreover, both CARF and anti-CCP had higher sensitivity of 66.7%, 61.5%, respectively, for the diagnosis of early RA than RF. On the other hand, MMP-3 is thought to be not only an evaluative test for the activity of RA because of its significant correlation with CRP, but also has potential as a prognostic test to identify joint damage from RA. Anti-CCP was also reported to associate with the progression of joint damage and may be also used as a prognostic test. We next examined the efficiency of RA diagnosis made by combining these laboratory tests. The specificity of RF was not as high as anti-CCP but reached 92% when combined with MMP-3. Thus, it is concluded that anti-CCP is superior to other laboratory tests in sensitivity and specificity, and that these combination assays are useful in the early diagnosis of RA.
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PMID:[New diagnostic and evaluative tests for rheumatoid arthritis]. 1751 Dec 71

In this study, we investigated the usefulness of contrast-enhanced MRI with maximum intensity projection (MIP) as a convenient tool for detecting early rheumatoid arthritis (RA). A total of 21 patients with undiagnosed arthritis of the hands at the initial visit were enrolled in a prospective study over a 1-year period. The number of swollen joints found during physical examination at this first visit, the results of serological tests and the number of synovitis joints diagnosed on MIP images were compared between the RA group and non-RA group. Of the 21 patients, 17 (81%) from the initial study who were followed up for an additional 1 year entered this study. Of these, 5 met the conditions for diagnosis of RA during follow-up, and 12 did not. MIP images were used to review the arthritis of RA patients, and a significant difference was found in the number of synovitis inflammations detected with MIP images when compared with findings after physical examinations. The two criteria of positive CARF and/or anti-CCP antibody and symmetrical synovitis in bilateral hands on MIP images allowed the prediction of RA with 100% sensitivity and 75% specificity. Thus, MIP is a useful tool for making early diagnosis of RA because it yields clear visualization even with just one image.
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PMID:Maximum intensity projection as a tool to diagnose early rheumatoid arthritis. 1831 77

Rheumatoid factor (RF) has been commonly used as a biomarker of rheumatoid arthritis (RA). It is important to diagnose RA early and to prevent joint destruction before irreversible damage occurs. For this purpose, several new biomarkers, such as anti-cyclic citrullinated peptide antibody (anti-CCP) and matrix metalloproteinase-3 (MMP-3), have become available for both the diagnosis and prognosis of RA. RF showed a tolerable sensitivity of 68.5% for RA, but low specificity of 77.1% for patients with other rheumatic diseases. Anti-agalactosyl IgG antibodies (CARF) showed a slightly higher sensitivity of 73.9%, but specificity as low as that for RF. In contrast, anti-CCP demonstrated high sensitivity of 76.1% and marked specificity of 92.4% for patients with other rheumatic diseases. Anti-CCP was significantly superior to other biomarkers on receiver-operating characteristic curve (ROC) analysis. Moreover, meta-analysis revealed that the pooled sensitivity and specificity were 67% and 95% for anti-CCP, and 69% and 85% for RF, respectively, and that anti-CCP was more specific than RF for diagnosing RA. On the other hand, MMP-3 has been suggested to be a prognostic biomarker as well as an evaluative biomarker for RA. We next examined if the diagnostic accuracy of early RA is improved by combining these biomarkers. The specificity of RF was not as high as anti-CCP but rose to 92% when combined with MMP-3. Thus, we concluded that anti-CCP is superior to other biomarkers in terms of diagnostic accuracy, and that these combined assays are useful in the early diagnosis of RA.
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PMID:[New biomarkers for rheumatoid arthritis]. 1851 64