Objective : This study was aimed to promptly review the literature regarding clinical usefulness of anti-CCP antibody tests in patients with rheumatoid arthritis to provide the basis of decision makings in the relevant policies.
Methods : In this study, data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES Ⅳ, 2007-2009) were analyzed to verify the prevalence of Korean patients with rheumatoid arthritis, and the existing systematic reviews were reviewed by using a frame suggested by the US AHRQ.
Results : The prevalence of patients with rheumatoid arthritis in Korea was 2.2% based on lifetime prevalence (a proportion of patients who have had rheumatoid arthritis at any time to date) or 1.9% based on the physician’s diagnosis (a proportion of patients who have been diagnosed with rheumatoid arthritis by a physician at any time in their life). In addition,based on the physician’s diagnosis was 0.803, lower than the mean quality of life index of 0.933 in general population, and also lowe r than that of patients with hypertension (0.865), diabetes mellitus (0.852), asthma (0.842), and angina pectoris(0.811). And, results from the analysis of the existing 9 systematic reviews on anti-CCP antibody tests indicated that their search DB, duration of search, and study objectives varied and that there were also difference s in terms of quality assessment for literature by AMSTAR. Nevertheless, there was no objection to the fact that sensitivity of anti-CCP antibody is similar to or higher than that of the rheumatoid factor and anti-CCP antibody has a markedly high level of specificity in the diagnosis of rheumatoid arthritis. It was also confirmed that the second generation anti-CCP antibody has a higher sensitivity and specificity than the first generation. These reviews conclude that this test is relevant to early diagnosis of rheumatoid art hritis and can help predict the probability of further progress to rheumatoid arthritis.
Conclusions : Results from the systematic review of HTA report and guidelines, existing systematic reviews, and systematic reviews of reports in Korean population support the consistent conclusion that the anti-CCP antibody test is both necessary and useful in the diagnosis of rheumatoid arthritis, and suggest that this test is expected to contribute to early treatment of patients with this disease by enhancing specificity in the diagnosis of rheumatoid arthritis, especially when the disease is in its early stage.
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