Products - Autoimmune - Rheumatology - Rheumatoid arthritis

Rheumatoid arthritis

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Disease information

Rheumatoid arthritis (RA) is an autoimmune disease which manifests as painful and swollen joints with restricted movements and progressive destruction. One of the hallmarks of the disease is morning stiffness in the joints that improves with activity. The overall worldwide prevalence of the disease clicks at around 0.5 to 1% , with the disease affecting women twice as commonly as men. Women between the ages 55 to 64 whereas men between 65 and 75 years of age mostly develop the disease.

Rheumatoid arthritis is usually gradual in onset. The disease process starts with the appearance of antibodies which on average is 3 to 4 or even 15 years before the first joint complaints. Two major antibodies are usually implicated in RA:

  • The rheumatoid factor which is an IgM autoantibody against IgG
  • Anti-citrullinated protein antibodies (ACPA).

ACPAs against citrullinated peptides play a highly predictive role in the diagnosis of rheumatoid arthritis. This can be ascertained from a surge in these antibodies during the change of undifferentiated arthritis to rheumatoid arthritis (RA). The presence of these antibodies helps in the early diagnosis of the disease.

Diagnostic Guidelines

Determination of ACPA is a chief protocol in the diagnosis of RA according to the guidelines of American College of Rheumatology (ACR). The detection of ACPA and rheumatoid factor (RA) goes hand in hand and helps to accurately diagnose the disease. Moreover, other indicators of an inflammatory process such as a high erythrocyte sedimentation rate (ESR), high WBC count and presence of C-reactive protein, all indicate an ongoing disease.

Anti-CCP ELISAs of the second generation are deemed gold standard for detection of ACPA. These antibodies which are mainly of class IgG are highly sensitive (80% at 98% specificity). They hold greater specificity than rheumatoid factor as they come positive in around 60% of the RA patients negative for the factor.

Citrullinated Enolase

Anti-citrullinated enolase peptide (anti-CEP1) antibodies are another useful marker for the disease diagnosis. Furthermore, these antibodies also help in risk stratification. Patients with anti-CEP1 usually follow an erosive disease course with concurrent interstitial lung diseases. Thus, not only do they allow disease differentiation but also help identify and understand disease pathogenesis.

Rheumatoid arthritis products

The individual product regulatory statements may vary, please refer to the instructions for use for more information.

wdt_ID Method Parameter Substrate Species/ Antigen
329 ELISA cyclic citrullinated peptides
(CCP)
antigen-coated
microplate wells
highly purified synthetic
CCP (second generation)
330 ELISA Sa antigen-coated
microplate wells
citrullinated Sa antigen
331 ELISA CEP-1 antigen-coated
microplate wells
citrullinated
alpha-enolase peptide
332 ELISA IgA rheumatoid factor
(ab of class IgA against IgG)
antigen-coated
microplate wells
IgG,
human
333 ELISA IgG rheumatoid factor
(ab of class IgG against IgG)
antigen-coated
microplate wells
IgG,
goat
334 ELISA IgM rheumatoid factor
(ab of class IgM against IgG)
antigen-coated
microplate wells
IgG,
human
335 ELISA circulating immune complexes
(CIC)
antigen-coated
microplate wells
native,
human C1q
336 ELISA MabTrack level adalimumab
337 ELISA MabTrack anti-drug antibody adalimumab
338 ELISA MabTrack level infliximab
339 ELISA MabTrack anti-drug antibody infliximab
Method Parameter Substrate Species/ Antigen
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