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Anti-CCP prognostic value — SCE Rheumatology MCQ

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HardMusculoskeletal InvestigationsAnti-CCP prognostic valueSCE Rheumatology

A woman with early inflammatory polyarthritis is rheumatoid-factor negative but strongly anti-CCP positive. Baseline radiographs show no erosions. What does the antibody result imply?

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Correct answer: B — A greater risk of persistent and erosive rheumatoid arthritis

The best answer is “A greater risk of persistent and erosive rheumatoid arthritis”. Strong anti-CCP positivity supports rheumatoid arthritis and predicts a higher risk of persistent erosive disease even when baseline radiographs are normal. It does not confer protection, diagnose lupus nephritis or establish crystal arthritis, and seronegativity would not itself exclude persistence.

Reference: NICE NG100 rheumatoid arthritis recommendations: https://www.nice.org.uk/guidance/ng100/chapter/Recommendations