Serum anti-cyclic citrullinated peptide antibodies before and after treatment by disease-modifying anti-rheumatic drugs

BACKGROUND: Rheumatoid arthritis (RA) is the most common chronic disease involving joints. Anti-cyclic citrullinated peptide (anti-CCP) as a specific antibody is a reliable index to early diagnosis of RA. Disease-modifying anti-rheumatic drugs (DMARDs) can reduce progression of RA joint destruction. The present study aimed to investigate the effects of DMARDs in reducing serum anti-CCP. METHODS: A cross-sectional study was performed on 30 patients including 22 females and 8 males RA patients according to the American College of Rheumatology (ACR) classification criteria, who referred to the Rheumatology Clinic. Treatment with DMARD group started at the beginning of the study (May 2009). At 1st and 6th month of the study, clinical findings and disease activities were recorded and anti-CCP was measured. RESULTS: At the beginning and the end of the study, morning stiffness for more than 1 h and involvement of three areas were, 28 (93%) and 12 (40%), respectively. Indicators of disease severity in patients, the mean ± SD serum levels of erythrocyte sedimentation rate at the beginning and end, were 40.7 (30-59) mm/1 h and 13.4 (9-86) respectively. Anti-CCP at the beginning and end of the study was 141.83 (65.8-101.09) U/ml and 65.8 (62-92) U/ml respectively (P < 0.05). Disease Activity Score in 28 joints and rheumatoid factor positive and C-reactive protein positive were significantly different at the onset and at the end of the study (P < 0.05). CONCLUSION: Measurement of serum anti-CCP is a helpful index of treatment response and monitoring of treatment efficacy in patients with RA