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CCP Antibody Test

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What is a CCP antibody test?

This test looks for CCP (cyclic citrullinated peptide) antibodies in the blood. CCP antibodies, also called anti-CCP antibodies, are a type of antibody called autoantibodies. Antibodies and autoantibodies are proteins made by the immune system. Antibodies protect you from disease by fighting foreign substances like viruses and bacteria. Autoantibodies can cause disease by attacking the body’s healthy cells by mistake.

CCP antibodies target healthy tissues in the joints. If CCP antibodies are found in your blood, it can be a sign of rheumatoid arthritis. Rheumatoid arthritis is a progressive, autoimmune disease that causes pain, swelling, and stiffness in the joints. CCP antibodies are found in more than 75 percent of people who have rheumatoid arthritis. They are almost never found in people who don’t have the disease.

Other names: Cyclic citrullinated peptide antibody, anticitrullinated peptide antibody, citrulline antibody, anti-cyclic citrullinated peptide, anti-CCP antibody, ACPA

What is it used for?

A CCP antibody test is used to help diagnose rheumatoid arthritis. It’s often done along with or after a rheumatoid factor (RF) test. Rheumatoid factors are another type of autoantibody. RF tests used to be the main test to help diagnose rheumatoid arthritis. But RF factors can be found in people with other autoimmune diseases and even in some healthy people. Many studies have shown that CCP antibodies provide a more accurate diagnosis of rheumatoid arthritis compared with RF testing.

Why do I need a CCP antibody test?

You may need this test if you have symptoms of rheumatoid arthritis. These include:

  • Joint pain
  • Joint stiffness, especially in the morning
  • Joint swelling
  • Fatigue
  • Low-grade fever

You may also need this test if other tests couldn’t confirm or rule out a diagnosis of rheumatoid arthritis.

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What happens during a CCP antibody test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

Be sure to tell your health care provider about all medicines, vitamins, and dietary supplements you are taking. You may need to stop taking certain substances for 8 hours before your test.

Are there any risks to the test?

There is very little risk of having a blood test. You may have slight pain or bruise at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

If your CCP antibody results were positive, it means these antibodies were found in your blood. A negative result means no CCP antibodies were found. The meaning of these results may depend on the results of a rheumatoid factor (RF) test as well as a physical exam.

If you have symptoms of rheumatoid arthritis, and your results show:

  • Positive CCP antibodies and positive RF, it likely means that you have rheumatoid arthritis.
  • Positive CCP antibodies and negative RF, it may mean you are in the early stages of rheumatoid arthritis or will develop it in the future.
  • Negative CCP antibodies and negative RF, it means you are less likely to have rheumatoid arthritis. Your provider may need to do more tests to help find out what is causing your symptoms.
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Is there anything else I need to know about a CCP antibody test?

Rheumatoid arthritis can be difficult to diagnose, especially in its early stages. Your provider may order one or more tests in addition to CCP antibody and RF tests. These include x-rays of your joints and the following blood tests:

  • Erythrocyte sedimentation rate (ESR)
  • Synovial fluid analysis
  • C-reactive protein
  • Antinuclear antibody

These blood tests can show signs of inflammation. Inflammation is a type of immune system response. It can be a symptom of rheumatoid arthritis.

References

  1. Abdul Wahab A, Mohammad M, Rahman MM, Mohamed Said MS. Anti-cyclic citrullinated peptide antibody is a good indicator for the diagnosis of rheumatoid arthritis. Pak J Med Sci. 2013 May-Jun [cited 2020 Feb 12]; 29(3):773-77. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809312
  2. American College of Rheumatology [Internet]. Atlanta: American College of Rheumatology; c2020. Glossary: Cyclic citrullinated peptide (CCP) antibody test; [cited 2020 Feb 12]; [about 3 screens]. Available from: https://www.rheumatology.org/Learning-Center/Glossary/ArticleType/ArticleView/ArticleID/439
  3. Arthritis Foundation [Internet]. Atlanta: Arthritis Foundation; Rheumatoid Arthritis; [cited 2020 Feb 12]; [about 3 screens]. Available from: https://www.arthritis.org/diseases/rheumatoid-arthritis
  4. Cleveland Clinic [Internet]. Cleveland (OH): Cleveland Clinic; c2020. Rheumatoid Arthritis: Diagnosis and Tests; [cited 2020 Feb 12]; [about 4 screens]. Available from: https://my.clevelandclinic.org/health/diseases/4924-rheumatoid-arthritis/diagnosis-and-tests
  5. Familydoctor.org [Internet]. Leawood (KS): American Academy of Family Physicians; c2020. Rheumatoid Arthritis; [updated 2018 Aug 28; cited 2020 Feb 12]; [about 3 screens]. Available from: https://familydoctor.org/condition/rheumatoid-arthritis
  6. HSS [Internet]. New York: Hospital for Special Surgery; c2019. Understanding Rheumatoid Arthritis Lab Tests and Results; [updated 2018 Mar 26; cited 2020 Feb 12]; [about 4 screens]. Available from: https://www.hss.edu/conditions_understanding-rheumatoid-arthritis-lab-tests-results.asp
  7. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2020. Autoantibodies; [updated 2019 Nov 13; cited 2020 Feb 12]; [about 3 screens]. Available from: https://labtestsonline.org/tests/autoantibodies
  8. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2020. Cyclic Citrullinated Peptide Antibody; [updated 2019 Dec 24; cited 2020 Feb 12]; [about 2 screens]. Available from: https://labtestsonline.org/tests/cyclic-citrullinated-peptide-antibody
  9. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2020. Inflammation; [updated 2017 Jul 10; cited 2020 Feb 12]; [about 3 screens]. Available from: https://labtestsonline.org/glossary/inflammation
  10. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2020. Rheumatoid Factor (RF); [updated 2020 Jan 13; cited 2020 Feb 12]; [about 2 screens]. Available from: https://labtestsonline.org/tests/rheumatoid-factor-rf
  11. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2020. Rheumatoid arthritis: Diagnosis and treatment; 2019 Mar 1 [cited 2020 Feb 12]; [about 4 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/diagnosis-treatment/drc-20353653
  12. Mayo Clinic Laboratories [Internet]. Mayo Foundation for Medical Education and Research; c1995–2020. Test CCP: Cyclic Citrullinated Peptide Antibodies, IgG, Serum: Clinical and Interpretive; [cited 2020 Feb 12]; [about 2 screens]. Available from: https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/84182
  13. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2020. Rheumatoid Arthritis (RA); 2019 Feb [cited 2020 Feb 12]; [about 2 screens]. Available from: https://www.merckmanuals.com/home/bone,-joint,-and-muscle-disorders/joint-disorders/rheumatoid-arthritis-ra
  14. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests; [cited 2020 Feb 12]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
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  16. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2020. Health Encyclopedia: CCP; [cited 2020 Feb 12]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=ccp
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