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Clinical value of second- and third-generation assays of anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis
  1. K Kitahara1,2,
  2. K Takagi1,
  3. Y Kusunoki1,
  4. S Nishio1,
  5. T Nozaki3,
  6. H Inomata3,
  7. M Takei3,
  8. S Sawada3,
  9. S Kawai1
  1. 1
    Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo, Japan
  2. 2
    Department of Immunology, Toho University School of Medicine, Tokyo, Japan
  3. 3
    Division of Haematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  1. Professor S Kawai, Division of Rheumatology, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan; skawai{at}

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Anti-cyclic citrullinated peptide (CCP) antibodies are useful for the diagnosis of rheumatoid arthritis (RA) because of their higher specificity.1 First-generation anti-CCP (CCP1) ELISAs were based on synthetic peptides derived from human filaggrin.2 The second-generation anti-CCP (CCP2) test, which contains epitopes selected from libraries of citrullinated peptides, performs better than anti-CCP1.3 4 Recently, a third-generation anti-CCP (CCP3) test was introduced. We compare the performance of the anti-CCP3 test with that of two anti-CCP2 tests, and assess their value in diagnosing RA.

A total of 502 participants were studied: 227 patients fulfilling the American College of Rheumatology criteria for RA,5 173 patients with non-RA autoimmune diseases (details are indicated …

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  • Competing interests: None.

  • Funding: This work was supported in part by the project research grant No 18-5 of Toho University School of Medicine to KK, by a research grant from the Japanese Ministry of Health, Labour and Welfare to SK and by research grants from SRL, Inc, Tokyo, Japan to SK and SS. The funding sponsors took no part in this study.

  • Ethics approval: Research ethics committee approval was obtained.

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