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Anti-CCP Antibodies in RA — RACP Adult Medicine MCQ

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EasyRheumatologyAnti-CCP Antibodies in RARACP Adult Medicine

A 45-year-old man presents with symmetric polyarthritis affecting MCPJs and PIPJs with morning stiffness lasting 2 hours. RF is negative but anti-CCP antibodies are strongly positive. CRP is 45 mg/L. What is the most accurate statement about anti-CCP antibodies?

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Correct answer: A — They are commonly positive in SLE

Anti-CCP (anti-citrullinated peptide) antibodies have a specificity of >95% for rheumatoid arthritis (compared to ~80% for RF). They are also more sensitive for RA than RF in early disease. Anti-CCP positivity predicts a more erosive, aggressive disease course. They can be present years before clinical disease onset. Anti-CCP positive, RF-negative patients still have RA – seronegative RA refers to absence of BOTH markers.

Reference: eTG – 2025 – Rheumatology; ACR/EULAR – 2010 – RA Classification Criteria