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Rheumatoid arthritis
Review
Measuring ACPA in the general population or primary care: is it useful?
  1. Axel Finckh,
  2. Delphine Courvoisier and
  3. Celine Lamacchia
  4. Recherche clinique en rhumatismes inflammatoires
    1. Division of Rheumatology, University Hospital of Geneva, Geneva, Switzerland
    1. Correspondence to Professor Axel Finckh; axel.finckh{at}hcuge.ch

    Abstract

    Rheumatoid arthritis (RA) is associated with a significant disease burden and high costs for society. Because the disease has identifiable preclinical stages, screening and prevention have become a possibility in RA. Anticitrullinated peptide antibodies (ACPAs) are arguably the most likely candidate biomarker to screen for RA. This paper reviews the evidence for the use of ACPAs as a screening test in the broader general population, to identify individuals at high risk of subsequent onset of RA. We will review the diagnostic properties of the test and its positive and negative predictive value in different settings. We will discuss how ACPA testing could effectively be integrated in a broader screening strategy for RA.

    • rheumatoid arthritis
    • health services research
    • Anti-CCP
    • autoantibodies
    http://creativecommons.org/licenses/by-nc/4.0/

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

    https://doi.org/10.1136/rmdopen-2019-001085

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      Footnotes

      • Collaborators Recherche clinique en rhumatismes inflammatoires: O. Studer, E. Trunk, B. Gilbert.

      • Contributors All authors have seen and approved the final manuscript and contributed significantly to this work (meet criteria for authorship).

      • Funding Study was funded by Fondation Jean et Linette Warnery.

      • Competing interests The author’s institution has a scientific collaboration with Inova and Thermofisher, 2 producers of ACPA tests. The research collaboration is scientific and does not involve any monetary compensation or other kind of benefits.

      • Patient consent for publication Not required.

      • Provenance and peer review Commissioned; externally peer reviewed.

      • Data availability statement No additional data are available.