The Frequency and Clinical Association of Anti-CCP Positivity in Patients with Psoriatic Arthritis (PsA) and its Significance in Skeletal Involvement
Anti-CCP Positivity and Skeletal Involvement in Psoriatic Arthritis
Abstract
Objectives: To determine the prevalence of anti-CCP antibodies in patients with PsA and evaluate their
association with clinical features.
Methodology: A cross-sectional study was conducted in the Department of Rheumatology, Liaquat National
Hospital, Karachi. Sixty-one (61) PsA patients fulfilling CASPAR criteria were enrolled. Clinical assessments
included joint distribution, axial/peripheral involvement, and skin manifestations. Anti CCP measured using
ELISA Kits (cut-off value: <17 U/mL), X-rays, MRI, or CT scans were utilized where available, as part of
routine clinical evaluation to characterize the pattern of skeletal involvement and were considered in conjunction with clinical findings to support the overall diagnosis. Associations between anti-CCP positivity and clinical features were analyzed using chi-square tests and logistic regression.
Results: Anti-CCP antibodies were detected in 31.1% of PsA patients. Anti-CCP positivity was significantly
associated with the absence of skin involvement (p 0.008) and older age (p=0.025). No significant associations
were observed between anti-CCP status and patterns of joint involvement, axial or peripheral disease. Logistic
regression demonstrated significantly lower odds of anti-CCP positivity in patients with skin involvement
(OR = 0.06, 95% CI: 0.006–0.582, p = 0.015).
Conclusion: A substantial proportion of PsA patients in this cohort tested positive for anti-CCP antibodies.
Anti-CCP positivity may represent a distinct clinical subset in PsA and was associated with older age and an
inverse relationship with skin involvement. It may also be associated with a distinct clinical pattern of
musculoskeletal involvement. These findings highlight the potential role of anti-CCP antibodies in the clinical
assessment of PsA and support their use in guiding diagnostic and therapeutic considerations.
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