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Diagnostic and prognostic value of antibodies against chimeric fibrin/filaggrin citrullinated synthetic peptides in rheumatoid arthritis
Arthritis Research & Therapy, 09/03/09

Sanmarti R et al. – CFFCP-based assays are highly sensitive and specific for RA. Early RA patients with anti-CFFCP1 antibodies, including CCP2-negative patients, show greater radiographic progression.

Methods

The diagnostic yield of three enzyme-linked immunoabsorbent assay (ELISA) tests using chimeric fibrin/filaggrin citrullinated synthetic peptides (CFFCP1, CFFCP2, CFFCP3) were compared with a commercial CCP2-based test in RA and analyzed their prognostic values in early RA
Samples from 307 blood donors and patients with RA (322), psoriatic arthritis (133), systemic lupus erythematosus (119), and hepatitis C infection (84) were assayed using CFFCP- and CCP2-based tests
Autoantibodies were also analyzed at baseline and during a 2-year followup in 98 early RA patients to determine their prognostic value.

Results

With cutoffs giving 98% specificity for RA vs blood donors, the sensitivity was 72.1% for CFFCP1, 78.0% for CFFCP2, and 71.4% for CFFCP3, and 73.9% for CCP2, with positive predictive values >97% in all cases
CFFCP sensitivity in RA increased to 80.4% without losing specificity when positivity was considered as any positive anti-CFFCP status
Specificity of the three CFFCP tests vs other rheumatic populations was high (>90%) and similar to those for the CCP2
In early RA, CFFCP1 best identified patients with poor radiographic outcome
Radiographic progression was faster in the small subgroup of CCP2-negative and CFFCP1-positive patients than those negative for both autoantibodies
CFFCP antibodies decreased after 1 year, but without any correlation with changes in disease activity

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