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Biological Significance of Anti–Cyclic Citrullinated Peptide Antibody in Rheumatoid Arthritis
- Kunihiro Nishimura, MD, MPH, PhD;
- Akio Morinobu, MD, PhD; and
- Shunichi Kumagai, MD, PhD
- From Harvard School of Public Health, Boston, MA 02215, and Kobe University Graduate School of Medicine, Hyogo, Japan 650-0017.
IN RESPONSE:
Dr. Roubenoff and colleagues and Dr. Arkfeld raise interesting points in their letters. We admit that early diagnosis of RA requires a combination of anti-CCP testing and other new biological markers or diagnostic imaging tests. However, currently available studies for these are too limited to conduct meta-analysis quantitatively. The aim of our study was to clarify the diagnostic value of anti-CCP testing from studies conducted so far.
We appreciate the opinion expressed by Dr. Roubenoff and colleagues and agree that anti-CCP–positive and –negative RA may be different subsets of RA and that levels of other biological markers, such as shared epitopes, play important roles in diagnosis. However, from the currently available evidence, we believe that …
