Anti Cyclic Citrullinated Peptide (Anti - CCP)

Anti-CCP positive means the blood contains anti–cyclic citrullinated peptide antibodies. Their presence strongly suggests rheumatoid arthritis, predicts a higher likelihood of developing RA, and is associated with more aggressive disease and greater risk of joint damage. Anti-CCP testing helps confirm diagnosis and guide early treatment decisions because it’s more specific for RA than many other autoimmune markers.

An anti-CCP level under 7 is generally considered negative, making rheumatoid arthritis less likely. However, early or seronegative RA can occur despite low anti-CCP. If joint pain, stiffness, or swelling persist, clinicians may repeat testing, check rheumatoid factor and inflammatory markers, use imaging, and refer to a rheumatologist for further evaluation and monitoring.

High anti‑CCP (anti‑cyclic citrullinated peptide) levels most commonly indicate rheumatoid arthritis, including early or seropositive RA and palindromic or undifferentiated inflammatory arthritis that may evolve into RA. They can also appear, less commonly, in other inflammatory or autoimmune conditions such as psoriatic arthritis, Sjögren’s syndrome, or systemic lupus erythematosus. Positive anti‑CCP predicts more aggressive, erosive joint disease.

Anti‑CCP (cyclic citrullinated peptide) antibody results are interpreted against lab-specific cutoffs. A “normal” (negative) result is typically below the laboratory’s reference limit—commonly <20 U/mL for many assays (some labs use <5–7 U/mL). Higher values are reported as low/medium/high positive and increase the likelihood of rheumatoid arthritis; interpret results with clinical context and specialist input.

Anti‑CCP positivity signals rheumatoid arthritis risk; treatment targets early, aggressive control: begin disease‑modifying antirheumatic drugs (DMARDs), typically methotrexate, with short‑term glucocorticoids for flares. If response is inadequate, add or switch to biologic or targeted agents (TNF inhibitors, IL‑6 or JAK inhibitors). Use NSAIDs for symptom relief, plus physiotherapy, smoking cessation, and regular monitoring.

Stress does not directly cause rheumatoid arthritis, but chronic stress can influence immune function and inflammation, potentially triggering flares or contributing to disease onset in people with genetic susceptibility. Stress also worsens symptoms through poor sleep, increased pain perception, and unhealthy coping behaviors. Managing stress can reduce flare risk and improve quality of life; discuss persistent stress or symptoms with your healthcare professional.