Diagnostics Worldwide
Autoimmune Diagnostics
Advances in the Diagnosis of Rheumatoid Arthritis Staged Multimarker Concept
> Cost-efficient Screening for High-Titer RF
> High Specificity for Early RA Diagnosis by Detection of Anti-CCP
> Increased Sensitivity by Sequential Testing with RF, CCP and RA33
> Prognosis of Disease Outcome Allows Individually Tailored Therapies
Early Diagnosis of Rheumatoid Arthritis
Rheumatoid Arthritis (RA) is a chronic, progressive, systemic
autoimmune disease characterized by persistent joint
inflammation. If left untreated the disease leads to systemic
complications, irreversible joint damage and invalidity.
For effective treatment, an early diagnosis of RA is essential.
Serologic markers can detect early-stage RA, thereby con-
tributing to an improved outcome of RA therapy and reduc-
tion of the severity of joint damage.
Serologic RA Markers
Rheumatoid Factor (RF) was long the sole serologic indicator
for RA, showing a sensitivity of 60 to 80 % and a specificity
of 90 %. In recent years new prognostic and diagnostic mark-
ers have been identified. The greatest potential has been
observed for antibodies against cyclic citrullinated peptides
(Anti-CCP). Anti-CCP antibodies have a specificity for RA of
The Staged Multimarker Concept
High titer RF (> 50 IU/ml), Anti-CCP and Anti-RA33
can occur independently in early-stage RA and can even
precede the development of clinical manifestations.
The sequential determination of RF, Anti-CCP and Anti-RA33
is an efficient and cost-effective strategy for routine diag-
nosis of early RA.
Appropriate Early Treatment
Prevention of Progressive Joint Damage
ReducedInvalidity
ReducedMortality
Anti-RA33hnRNP-A2 Antibodies
mild prognosis
Anti-CCPcyclic citrullinated peptidesevere, erosive prognosis
RF 50 ≥ lU/mlRheumatoid Factor
severe, erosive prognosis
Diagnosis of Rheumatoid Arthritis
at least 98 % and a sensitivity that is comparable to that of
RF reaching 75 % in established RA. Another well-character-
ized marker is the autoantibody against hnRNP-A2 (Anti-
RA33). Anti-RA33 is detectable in one third of RA patients and
shows specificity similar to RF. Antibodies against RA33 are
associated with a less severe form of the disease.
High risk of developing RAHigh risk of developing erosive disease
Increased risk of developing RAGood prognosis
Anti-RA33
Decreased risk of developing RA
Adapted from reference 3
negative
negative
positive
positive
≥ 50 U/ml
Anti-CCP
Anti-RF
Suspicion of Rheumatoid Arthritis (RA)
Diagnostics WorldwideHUMAN Gesellschaft für Biochemica und Diagnostica mbH Max-Planck-Ring 21 · 65205 Wiesbaden · GermanyTel. +49 6122-9988-0 · Fax +49 6122-9988-100 · e-mail: [email protected] · www.human.de
Enzyme Immunoassays Cat. No.
IMTEC-RF Screen 96 Tests ITC60000
ELISA for the quantitative determination
of rheumatoid factors (Ig(GAM))
IMTEC-CCP-Antibodies 96 Tests ITC60021
ELISA for the quantitative determination
of Anti-CCP antibodies (IgG)
IMTEC-RA33-Antibodies 96 Tests ITC60015
ELISA for the quantitative determination
of Anti-RA33 antibodies (IgG)
With the IMTEC product line HUMAN offers the broadest
test portfolio for a complete up-to-date diagnosis of early
rheumatoid arthritis.
Enzyme Immunoassays Cat. No.
IMTEC-RF IgM 96 Tests ITC60003
ELISA for the quantitative determination
of rheumatoid factors (IgM)
IMTEC-RF IgG 96 Tests ITC60007
ELISA for the quantitative determination
of rheumatoid factors (IgG)
IMTEC-RF IgA 96 Tests ITC60010
ELISA for the quantitative determination
of rheumatoid factors (IgA)
9815
90/G
B/20
10-1
1 ©
201
0 H
uman
Gm
bH
References1. Lee & Schur, Ann Rheum Dis, 2003; 62: 870-874
2. Lindquist et al., Ann Rheum Dis, 2005; 64:196-201
3. Nell et al., Ann Rheum Dis, 2005; 64:1731-1736
4. Nielen et al., Arthritis & Rheumatism, 2004; 50:380-386
5. Pruijn et al., Current Rheum Reviews, 2005; 1:1-7
6. Rantapää-Dahlqvist et al., Arthritis & Rheumatism, 2003;
10:2741-2749
7. Sauerland et al., Ann N.Y. Acad Sci, 2005; 1050: 314-318
8. Van Gaalen et al., Arthritis, 2004; 50:709-715
9. Visser et al., Arthritis and Rheumatism 2002; 46:357-65
Diagnosis of Rheumatoid ArthritisIMTEC Product Line
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