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Anti-CCP vs. ACPA: What's the Difference?

Edited by Aimie Carlson || By Harlon Moss || Published on February 26, 2024
Anti-CCP are antibodies specifically targeting cyclic citrullinated peptides, often indicating rheumatoid arthritis, while ACPA (anti-citrullinated protein antibodies) is a broader category including anti-CCP.

Key Differences

Anti-CCP antibodies are highly specific markers for rheumatoid arthritis, targeting cyclic citrullinated peptides. ACPA encompasses a wider range of antibodies, including anti-CCP, that react against citrullinated proteins.
The presence of anti-CCP is strongly associated with a more severe form of rheumatoid arthritis. ACPA, while also linked to rheumatoid arthritis, covers a broader spectrum of antibody types.
Anti-CCP tests are often used for early diagnosis of rheumatoid arthritis due to their high specificity. ACPA tests, though similar, may detect a wider range of citrullinated protein antibodies.
In terms of prognosis, high levels of anti-CCP are indicative of aggressive disease progression. ACPA levels also correlate with disease severity, but not as specifically as anti-CCP.
Treatment strategies for rheumatoid arthritis may be influenced by anti-CCP levels, as they indicate a more severe disease course. ACPA detection also aids in treatment planning, though its indications are broader.

Comparison Chart


High specificity for rheumatoid arthritis
Broader category of antibodies


Cyclic citrullinated peptides
Various citrullinated proteins

Disease Association

Strongly associated with severe RA
Associated with RA, but less specific

Diagnostic Use

Used for early RA diagnosis
Used for RA diagnosis, less specific

Prognostic Value

Indicates aggressive disease progression
Correlates with disease severity

Anti-CCP and ACPA Definitions


Specific to cyclic citrullinated peptides.
The anti-CCP test is highly specific compared to other RA markers.


Used to assess RA severity.
The doctor checked ACPA levels to gauge the severity of her RA.


Indicators of a more severe form of RA.
Elevated anti-CCP suggested a more aggressive RA treatment was needed.


Antibodies against citrullinated proteins.
ACPA presence can indicate rheumatoid arthritis.


Reflect the autoimmune nature of RA.
Anti-CCP antibodies are a clear sign of the body's immune response in RA.


Assist in the diagnosis of RA.
Her ACPA levels were measured to confirm RA.


Markers used in diagnosing rheumatoid arthritis.
Her positive anti-CCP test led to an early RA diagnosis.


Indicative of immune system activity against citrullinated proteins.
High ACPA levels suggest an active immune response in RA patients.


Antibodies targeting cyclic citrullinated peptides.
The patient's high anti-CCP levels indicated a likelihood of rheumatoid arthritis.


Broader category including various antibodies.
The ACPA test screens for a range of antibodies linked to RA.


How is anti-CCP used in healthcare?

Anti-CCP is used to diagnose and assess the severity of rheumatoid arthritis.

What are anti-CCP antibodies?

Anti-CCP antibodies specifically target cyclic citrullinated peptides and are indicators of rheumatoid arthritis.

Are ACPA and anti-CCP the same?

No, anti-CCP is a specific type of ACPA with a high specificity for rheumatoid arthritis.

What does a positive anti-CCP test indicate?

A positive anti-CCP test strongly suggests the presence of rheumatoid arthritis.

What does ACPA stand for?

ACPA stands for anti-citrullinated protein antibodies, a group of antibodies associated with rheumatoid arthritis.

What is the role of ACPA in the immune system?

ACPA reflects the immune system's response against citrullinated proteins, often seen in RA.

How accurate is the anti-CCP test?

The anti-CCP test is highly accurate and specific for diagnosing rheumatoid arthritis.

Can anti-CCP be used to monitor RA treatment?

Anti-CCP can be used to monitor disease progression, but not commonly for treatment response.

Can ACPA be used to predict RA severity?

Yes, ACPA can indicate the severity of RA, but it's less specific than anti-CCP.

Are there any risk factors for high anti-CCP levels?

Genetic factors and smoking are associated with higher anti-CCP levels.

Does a high anti-CCP level affect treatment?

High anti-CCP levels can influence the choice and intensity of RA treatment.

Is ACPA testing expensive?

The cost of ACPA testing varies but is generally considered affordable in most healthcare settings.

Is anti-CCP present in other diseases?

Anti-CCP is highly specific to rheumatoid arthritis and rarely present in other conditions.

Can anti-CCP levels decrease with treatment?

Anti-CCP levels typically remain stable and do not significantly decrease with treatment.

Is ACPA testing recommended for all arthritis patients?

ACPA testing is primarily recommended for patients suspected of having rheumatoid arthritis.

Can ACPA levels change over time?

Yes, ACPA levels can change and often increase with the progression of RA.

What other tests are used alongside anti-CCP?

Rheumatoid factor (RF) tests are often used alongside anti-CCP for diagnosing RA.

Can ACPA be negative in RA patients?

Yes, some RA patients can have a negative ACPA test.

How is ACPA testing performed?

ACPA testing is performed using a blood sample to detect the presence of these antibodies.

Are there specific symptoms associated with high ACPA levels?

High ACPA levels are associated with more severe RA symptoms.
About Author
Written by
Harlon Moss
Harlon is a seasoned quality moderator and accomplished content writer for Difference Wiki. An alumnus of the prestigious University of California, he earned his degree in Computer Science. Leveraging his academic background, Harlon brings a meticulous and informed perspective to his work, ensuring content accuracy and excellence.
Edited by
Aimie Carlson
Aimie Carlson, holding a master's degree in English literature, is a fervent English language enthusiast. She lends her writing talents to Difference Wiki, a prominent website that specializes in comparisons, offering readers insightful analyses that both captivate and inform.

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