Comparison of Threshold Cutpoints and Continuous Measures of Anti-Cyclic Citrullinated Peptide Antibodies in Predicting Future Rheumatoid Arthritis

摘要: Objective. Anti-cyclic citrullinated peptide (anti-CCP) antibodies are strongly associated with increased risk of rheumatoid arthritis (RA).While the anti-CCP level is commonly dichotomized for clinical use, best threshold and utility titer as a continuous variable to predict development RA uncertain. Methods. Using data from Nurses’ Health Study II longitudinal cohorts, we examined sensitivity, specificity, hazard at various thresholds anti-CCP. Incident was confirmed using Connective Tissue Disease Screening Questionnaire medical record review in 93 women among 62,437 participants blood samples. Three controls per case were randomly chosen, matching on cohort, age, menopausal status. Stored plasma tested second-generation Diastat™ ELISA. Five values assessed time diagnosis RA. Hazard conditional logistic regression models adjusting smoking reproductive factors. Results. suggested > 5 U/ml positivity, specificity 100%, but sensitivity only 28%. A 2 had higher (51%), similar (80%), an odds ratio 11.2 (95% confidence interval 4.7–26.9) Anti-CCP ordinal onset, predicting shorter onset. Conclusion. lower positivity more sensitive development. Higher ranges informative