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"Background. Rheumatoid Arthritis (RA) is one of the diseases associated with the immune system which causes joint damage and effect to the quality of patients life. DAS28 CRP value describes RA disease activity. The antiCCP titer is a very specific examination which provide an overview prognosis of RA patients illness. The research on the correlation of anti CCP Titers with DAS28 CRP values has never been done in Indonesia. Therefore, this research aims to determine the correlation between anti CCP Titer and DAS28 CRP value in RA patient in Cipto Mangunkusumo hospital with DAS28 CRP value in RSCM.Method. The research design is crosssectional with the sample amounted to 34. anti CCP and DAS28 CRP were obtained through patients medical records.Result. The result of this correlationstudy is (p = 0,582) and r = 0,086.Conclusion. In conclusion, there is no correlation between antiCCP and DAS28 in Cipto Mangunkusumo hospital."

"Artritis Reumatoid AR merupakan penyakit inflamasi sistemik kronik yang menyerang dan merusak sendi-sendi pada tungkai atas dan bawah. AR menyebabkan morbiditas dan disabilitas yang dapat menurunkan kualitas hidup Inflamasi kronis seiring dengan progresivitas penyakit menyebabkan penurunan indeks massa tubuh pada pasien AR. Titer Anti-CCP yang bersifat spesifik terhadap AR dapat menggambarkan progresivitas dan prediksi keparahan penyakit. Penelitian mengenai titer anti-CCP dan indeks massa tubuh belum dilakukan di Indonesia. Sehingga penelitian ini dilakukan dengan tujuan mengetahui korelasi antara titer anti-CCP dengan nilai indeks massa tubuh IMT di RSCM. Desain penelitian yang digunakan adalah cross-sectional dengan jumlah sampel sebanyak 42 rekam medis. Data mengenai titer anti-CCP, berat badan, tinggi badan, dan nilai indeks massa tubuh diperoleh dari rekam medis pasien. Hasil penelitian menunjukkan bahwa tidak terdapat korelasi antara titer anti-CCP dengan nilai indeks massa tubuh p>0.05; r-0.03.

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Rheumatoid arthritis is a chronic systemic inflammation that attacks and damages joints of upper and lower extremities. RA causes morbidity and disability, hence, affects the quality of life. Chronic inflammation, as the disease progressing, causes lowering of body mass index in RA patients. Titer of Anti CCP, which is specific for RA, indicates the progressivity and severity of the disease. Study about anti CCP titer and body mass index has not been done in Indonesia. Therefore, this study rsquo s done to understand the correlation between anti CCP titer and body mass index score in Rheumatoid Arthritis patients in RSCM. The design of this study is cross sectional study with 42 samples. The data including anti CCP titer, body weight, height, and body mass index are collected from patients rsquo medical records. The result of this study shows that there is no correlation between anti CCP titer and body mass index score in Rheumatoid Arthritis patients in RSCM p 0.05 r 0.03."

"Background rheumatoid arthritis (RA) is one of the diseases associated with the immune system which causes joint damage and effect to the quality of patients life. DAS28 CRP value describes RA disease activity. The anti ccp titer is a very specific examination which provoide an overview progonosis of RA pantients illness. the research on the corellation of anti ccp titers with DAAS28 CRP values has never been done in Indonesia."

"Artritis Reumatoid AR merupakan salah satu penyakit yang berhubungan dengan sistem imun yang menyebabkan kerusakan sendi dan mengakibatkan terjadi penurunan kualitas hidup pasien. Nilai DAS28 CRP menggambarkan aktivitas penyakit AR. Titer Anti-CCP merupakan pemeriksaan yang sangat spesifik digunakan untuk memberikan gambaran prognosis penyakit pasien AR. Penelitian tentang korelasi titer Anti-CCP dengan nilai DAS28 CRP belum pernah dilakukan di Indonesia. Oleh karena itu, penelitian ini bertujuan untuk mengetahui korelasi antara titer Anti-CCP dengan nilai DAS28 CRP di RSCM. Pada peneltian ini desain penelitian yang digunakan adalah cross-sectional dengan sampel berjumlah 43 data. Data mengenai titer Anti-CCP dan DAS28 CRP didapatkan melalui rekam medis pasien. Hasil menyatakan bahwa tidak terdapat korelasi p=0,582 antara titer Anti-CCP dengan DAS28 CRP dengan nilai r yang menunjukkan korelasi sangat lemah r=0,086.

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Rheumatoid arthritis is one of a disease relating with immunity that causes destruction in joints which affects quality of life of its patients. DAS28 CRP score represents the activity of the disease. Anti CCP titer is a specific test to portray the prognosis for the patients. Study about correlation between DAS28 CRP score and Anti CCP titer has not been done in Indonesia. Therefore, this study rsquo s done to understand the correlation between DAS28 CRP score and Anti CCP titer in RSCM. The design of this study is cross sectional study with 43 samples. Data of Anti CCP score and DAS28 CRP score are collected from patients rsquo medical records. The result of this study shows that there is no correlation between Anti CCP titer and DAS 28 CRP score in Rheumatoid Arthritis patients in RSCM with a very low correlation p 0,582 r 0,086."

"Pada awal penyakit diagnosis Artritis reumatoid (AR) sering dikacaukan dengan Lupus eritematosus sistemik (LES). Persendian terutama pada tangan dapat terserang pada kedua penyakit, sehingga pasien LES sering salah diagnosis sebagai AR. Oleh karena hasil-akhir dari kedua penyakit ini sangat berbeda , maka dibutuhkan suatu marker serologik untuk membedakan keduanya pada saat awitan penyakit. Antibodi anti-citrullinated peptide (anti ?CCP) telah dilaporkan sangat spesifik pada AR. Tujuan penelitian ini untuk memastikan spesifitas antibodi anti-CCP pada AR dan kemungkinan antibodi ini dapat membedakan pasien RA dari SLE. Penelitian ini suatu studi potong-lintang pada pasien AR (n=27), LES dengan artritis (n=20). penyakit otoimun lain (non-reumatik, n=8) dan kontrol dewasa (n=20). Anti-CCP diperiksa dengan cara Elisa dan faktor-reumatoid (FR) dengan uji latex. Sensitivitas dan spesifitas anti-CCP untuk diagnosis RA adalah 63.0% dan 97.9%, dibandingkan dengan FR yang hanya sebesar 40.7% dan 85.4%. Hanya 1 dewasa sehat dengan anti-CCP+, tidak satupun pasien LES maupun pasien penyakit otoimun lain yang mempunyai anti-CCP+. Nilai rerata titer anti-CCP pada dewasa sehat, penyakit otoimun lain, LES dan AR berturut-turut sebesar 1.35 ± 2.04, 0.63 ± 0.59, 0.75 ± 0.59, and 38.17 ± 44.22 RU/ml. Terdapat perbedaan sangat bermakna di antara titer anti-CCP pada pasien AR dengan yang lainnya (p<0.001). Disimpulkan bahwa deteksi anti-CCP sangat berguna untuk diagnosis AR, dan untuk membedakan AR dari LES. (Med J Indones 2004; 13: 227-31)

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Diagnosis of Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) can be confused in their initial stages. The joints, especially the hands, are commonly affected in both disorders, many patients with SLE are initially misdiagnosed as having RA Given that the outcome for the two diseases is diverse, it would be helpful to have serological marker to distinguish between them at onset. Anti-citrullinated peptide antibodies (anti-CCP) have recently been described as highly specific for RA. The objective of this study is to confirm the specificity of anti-CCP antibodies and to determine whether they might distinguish patients with RA from those with SLE. This study is a cross sectional study on a group of patients with RA (n=27), SLE with arthritis (n=20), other autoimmune diseases (non-rheumatic diseases, n = 8), and healthy adults (n=20). Anti-CCP was determined by a commercial Elisa test and Rheumatoid factor (RF) was determined by the standard slide latex test. The sensitivity and specificity of anti-CCP for the diagnosis of RA was 63.0% and 97.9% respectively, comparing with RF for RA that was 40.7 % and 85.4 %. Only 1 healthy adult was anti-CCP+, no anti-CCP was detected from SLE and other autoimmune disease. The mean of titer anti CCP in normal healthy adult, other autoimmune diseases, SLE and RA was 1.35 ± 2.04, 0.63 ± 0.59, 0.75 ± 0.59, and 38.17 ± 44.22 RU/ml, respectively. There was a highly significant difference between the mean of titer anti CCP for RA with others diseases (p<0.001). We conclude that detection of anti-CCP is very useful for the diagnosis of RA and distinguishing RA from SLE. (Med J Indones 2004; 13: 227-31)."

"Latar Belakang: Skor Clinical Disease Activity Index CDAI , sebagai salah satu metode pengukur derajat aktivitas artritis reumatoid AR , dipandang memiliki kelebihan dibandingkan metode skor lain karena tidak memerlukan pemeriksaan laboratorium penunjang. Studi-studi yang dilakukan pada pasien AR di luar Indonesia mengungkap bahwa korelasi, validitas dan reliabilitas CDAI dinilai baik saat diuji dengan pembanding skor lain. Namun demikian studi-studi tersebut hanya mengikutsertakan subjek pasien AR murni tanpa komorbiditas. Pasien AR di Indonesia memiliki karakteristik klinis yang berbeda, terutama dalam aspek adanya kondisi komorbiditas, perbedaan predisposisi genetik dan perbedaan fenotipe penyakit. Tujuan: Menilai validasi skor CDAI pada profil pasien AR di Indonesia. Metode: studi potong lintang pada subjek pasien AR yang berobat di poliklinik Reumatologi RS Cipto Mangunkusumo bulan April s.d. Mei 2016. Setiap subjek dilakukan anamnesis, pemeriksaan fisik, pencatatan hasil pemeriksaan penunjang dan pencatatan data komorbiditas yang tertera di rekam medis. Dua pengukur melakukan penghitungan skor CDAI dan skor Disease Activity Score 28 DAS28-CRP sebagai baku emas pembanding pada tiap subjek. Luaran berupa data numerik. Penilaian model validasi data numerik dilakukan dengan analisis performa model prediktor menggunakan indeks R 2. Hasil: Terdapat 119 subjek penelitian yang memenuhi kriteria inklusi. Seluruh subjek memiliki kondisi komorbiditas selain AR. Indeks R 2 =0,831 83,1.

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Background: Clinical Disease Activity Index CDAI stands out amongst other methods in measuring disease activity of rheumatoid arthritis RA patient. CDAI is considered to be more practical and cost effective in daily practice because it requires no laboratory examination. Previous studies conducted overseas revealed that CDAI has good correlation, validity, and reliability compared with other scoring methods. However, those studies included only pure RA subjects. Indonesian RA patients have distinct clinical profiles, in terms of comorbidity diseases, genetic predisposition, and fenotype of the disease.

Objectives: To analyze validation of CDAI in distinct clinical profiles of RA patients in Indonesia.

Methods: A cross sectional study in RA outpatients, who were visiting Rheumatology Clinic in RSCM on monthly basis from April to May 2016. Assesement of each patient include history taking and physical examination. All recent laboratory results and other data in medical record were documented in reseacher form. CDAI and Disease Activity Score 28 CRP DAS28 CRP, as gold standard, were measured by two observers. Outcomes were in numeric. Validation measurement were done in terms of validating a model prediction and quantifying how good the predictions from the model are. Overall perforomance were measured with R 2 index.

Result: A total of 119 subjects met the inclusion criteria. All subjects were RA patients with comorbidities and were representing quite numbers of Indonesian races characteristic profile. R 2 0,831 83,1 p"

"Latar belakang: Kejadian aterosklerosis pada pasien artritis reumatoid (AR) dilaporkan semakin lama semakin meningkat. Penyebab aterosklerosis pada AR tidak hanya disebabkan oleh faktor risiko tradisional, akan tetapi antibodi anti-CCP yang merupakan autoantibodi spesifik pada AR juga berperan dalam patogenesis aterosklerosis. Data prevalensi aterosklerosis dan penelitian mengenai hubungan antara antibodi anti-CCP dengan aterosklerosis belum pernah dilakukan pada populasi pasien AR di Indonesia. Tujuan: Mengetahui prevalensi aterosklerosis pada pasien AR dan menentukan asosiasi antara antibodi anti-CCP dengan aterosklerosis pada pasien AR. Metode: Penelitian ini menggunakan desain potong lintang dan pengambilan sampel dilakukan dengan metode consecutive. Subjek penelitian adalah pasien AR dewasa berusia diatas 18 tahun yang didiagnosis sesuai kriteria ACR/ EULAR 2010 yang datang berobat ke Poliklinik Reumatologi RSCM pada bulan September 2012 sampai Maret 2013. Antibodi anti-CCP diperiksa dengan metode ELISA. Adanya aterosklerosis ditentukan melalui pemeriksaan USG karotis bilateral yang dilakukan oleh satu orang operator dan tidak mengetahui latar belakang klinis pasien. Hubungan antara anti-CCP dengan aterosklerosis dinilai dengan menghitung crude odds ratio (OR) disertai interval kepercayaan (IK) 95%-nya. Peran variabel perancu dinilai dengan menggunakan analisis regresi logistik untuk mendapatkan adjusted OR. Hasil: Dari 86 subjek penelitian didapatkan 90,7% berjenis kelamin perempuan dengan median usia 49,5 (rentang 20 sampai 70) tahun. Prevalensi aterosklerosis didapatkan sebesar 50% (IK95% 0,39 – 0,61). Proporsi aterosklerosis pada kelompok subjek dengan antibodi anti-CCP positif (51,5%) tidak jauh berbeda dengan kelompok antibodi anti-CCP negatif (49,1%). Setelah disesuaikan dengan beberapa variabel perancu, tidak didapatkan hubungan yang bermakna antara antibodi anti-CCP dengan aterosklerosis (adjusted OR 1,197; IK95% 0,43 - 3,29). Simpulan: Prevalensi aterosklerosis pada pasien AR sebesar 50% (IK95% 0,39 - 0,61). Tidak didapatkan hubungan yang bermakna antara antibodi anti-CCP dengan aterosklerosis pada pasien AR.

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Background: Atherosclerosis is markedly increased in patients with rheumatoid arthritis (RA). Traditional risk factors not only account for atherosclerosis but also autoantibodies in RA especially anti-cyclic citrullinated peptides (anti-CCP) is the one of autoantibody highly specific for RA play a role in the pathogenesis of atherosclerosis. However, in Indonesia there was no data regarding the prevalence of atherosclerosis in RA patients.

Objectives: The aim of this study was to described the prevalence of atherosclerosis and to determine the association of anti-CCP antibodies with atherosclerosis in RA patients.

Methods: A cross sectional study was conducted in Rheumatology outpatient clinic Department of Internal Medicine, Cipto Mangunkusumo Hospital with consecutive sampling. Study subjects were recruited from September 2012 to March 2013 that RA patients diagnosed according to American College of Rheumatology (ACR)/ European League Againts Rheumatism/ (EULAR) 2010 criteria. Anti-CCP antibodies was determined by enzyme-linked immunosorbent assays (ELISA) test. Carotid intima-media thickness represent of atherosclerosis was measured by using Ultrasound (USG B-mode) and it was done by one independent operator without knowing clinical background of the patients. Association of anti-CCP with atherosclerosis was performed by chi-square test in order to get crude odds ratio (OR) with CI95% and logistic regression test was assigned to obtain adjusted OR.

Results: Out of eighty six RA patients aged 20 to 70 years old revealed in this study with median age 49.5 years and female gender as the commonest (90.7%). Fourty three (50%; CI95% 0.39 to 0.61) RA patients had carotid atherosclerosis. Atherosclerosis in RA patients with anti-CCP positive was seen in 51.5% and 49.1% in anti-CCP negative. After a set of adjustment towards the confounding factors, there was no significant association between anti-CCP antibodies and atherosclerosis (adjusted OR 1.197; CI95% 0.43 to 3.29).

Conclusion: This study demonstrates that the prevalence of atherosclerosis in RA patient is 50% (CI95% 0.39 to 0.61). The role of anti-CCP antibodies and atherosclerosis in patients with RA did not hold in this study."

"Latar Belakang: Penyakit kardiovaskular adalah penyebab kematian yang paling sering pada pasien AR dengan laju1,5-1,6 kali lebih tinggi dari populasi non AR. Prevalensi gagal jantung pada AR dua kali lipat dibanding non AR. Karakteristik pasien AR Indonesia berbeda dibanding pasien di Negara Barat. Masih sedikit penelitian yang melihat korelasi faktor resiko non tradisional dengan disfungsi diastolik. Tujuan: Mengetahui apakah ada korelasi faktor resiko non tradisional yaitu lama menderita penyakit, derajat aktivitas penyakit dan skor disabilitas dengan disfungsi diastolik pada wanita penderita AR. Metode: Desain penelitian adalah potong lintang pada wanita penderita AR yang berobat ke poli Rematologi RSCM dari Oktober 2015-Januari 2016.Sampel penelitian belum pernah dinyatakan menderita penyakit jantung sebelumnya.Disfungsi diastolik dinilai secara ekhokardiografi. Lama menderita sakit diperoleh dengan wawancara langsung, sementara aktivitas penyakit dan tingkat disabilitas dinilai dengan menghitung skor DAS28 dan skor HAQ-DI. Hasil: Disfungsi diastolik dijumpai pada 30,8 % partisipan ( masing-masing 13,5% tingkat ringan dan sedang, dan berat sebesar 3,8% ). Rerata lama menderita AR 26,5 bulan (rentang 2-240), rerata DAS28-CRP 2,69±1,11 sementara DAS28-LED 3,65 (rentang 1,13-7,5), rerata skor HAQ-DI 0,29 (rentang 0-2,38). Hipertropi LV dijumpai pada 34,6% partisipan, rerata EF 66,7±5,76%. Kelainan katup dijumpai pada 34,6% partisipan. Korelasi antara lama sakit, DAS28-CRP, DAS28-LED and skor HAQDI dengan E/A secara berurutan adalah (r= - 0,065; p=0,89), (r=0,393; p=0,38), (r=0,357; p=0,43), (r=0,630; p=0,12) ; sementara dengan E/E? secara berurutan adalah (r=0,136; p=0,77), (r= - 0,536; p=0,21), (r= - 0,393; p=0,38), (r=0,374; p=0,41). Simpulan: Lama menderita sakit, derajat aktivitas penyakit dan derajat disabilitas, tidak memiliki korelasi yang bermakna secara statistik dengan disfungsi diastolik. Angka hipertropi jantung juga cukup tinggi, dan kelainan katup yang paling sering di jumpai adalah regurgitasi ringan.Dengan tingginya angka proporsi disfungsi diastolik pada penelitian ini maka diusulkan agar dirumuskan strategi penatalaksanaan jantung pada pasien-pasien AR untuk mencegah progresifitasnya.

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Background: Cardiovascular is the main cause of death in RA, with the rate of 1.5-1.6 times higher than non RA population .The prevalence of HF in RA is 2 times fold of non RA. RA patients characteristics in Indonesia is different from the ones in western. There are only few studies about correlation between non traditional risk factor and diastolic dysfunction in RA patients.

Objective: To study the correlation between each of the non traditional risk factors including disease duration,disease activity and disability score with the diastolic dysfunction in women with RA.

Methods: A cross-sectional, consecutive sampling study conducted to 52 RA women without any previous history of cardiovascular disease. All participants underwent an echocardiography to asses the diastolic dysfunction and other findings associated. Duration of disease is assesed by direct interview, while the disease activity by calculating DAS28 and disability sore by HAQ-DI.

Results: Diastolic dysfunction was found in 30.8 % of study participants ( 13.5 % for each low and moderate grade, while severe was 3.8% ). Mean of disease duration was 26.5 months (range 2-240), mean DAS28-CRP 2.69±1.11 while mean DAS28-ESR 3.65 (range 1.13-7.5), HAQ-DI score 0.29 (range 0-2.38). LV hypertrophy was found in 34.61% participants. Mean EF 66.7±5.76%. Valve abnormality was found in 34.6% study participants. Correlation between duration of disease, DAS28-CRP, DAS28-ESR and HAQDI score with E/A in sequence was (r= - 0.065; p=0.89), (r=0.393; p=0.38), (r=0.357; p=0.43), (r=0.630; p=0.12) ; while with E/E? in sequence was (r=0.136; p=0.77), (r= - 0.536; p=0.21), (r= - 0.393; p=0.38), (r=0.374; p=0.41).

Conclusions; Duration of the disease, the disease activity score and disability score in our RA study participants had no correlation with diastolic dysfunction. The most valvular abnormality findings was mild regurgitation. Since there was a big proportion of participants with diastolic dysfunction, it is encouraged to make a stepwise approach of cardiovascular management in patients with RA."

"Artritis rematoid merupakan penyakit otoimun sistemik yang paling sering ditemukan di dunia pada berbagai populasi dan ras, ditandai oleh inflamasi menetap pada jaringan sendi yang meliputi sendi perifer, distribusi simetris, dengan atau tanpa kerusakan rawan sendi dan erosi tulang. Pemantauan aktivitas penyakit diperlukan untuk menentukan keberhasilan terapi. Selama ini, pemantauan aktivitas penyakit menggunakan Disease Activity Score 28 (DAS28), meskipun terdapat kekurangan berupa parameter klinis yang bersifat subjektif, menggunakan perhitungan yang rumit, dan terdapat ketidakseragaman nilai titik potong derajat aktivitas penyakit pada berbagai penelitian. Penelitian ini merupakan penelitian potong lintang untuk menilai korelasi antara kadar anti-CCP serum dan cairan sendi dengan aktivitas penyakit (DAS28) pada 30 subjek dengan artritis rematoid. Subjek yang memenuhi kriteria masukan dan tidak ada kriteria tolakan dilakukan penentuan skor DAS28 serta pemeriksaan anti-CCP serum dan cairan sendi. Median (rentang) kadar anti-CCP serum secara keseluruhan, pada tingkat aktivitas penyakit sedang, dan berat adalah 112.23 (1.02-1853.07), 70.98 (1.02-1224.07), dan 157.59 (1.07-1853.07) RU/mL. Median (rentang) kadar anti-CCP cairan sendi secara keseluruhan, pada tingkat aktivitas penyakit sedang dan berat adalah 85.54 (0.90-4150.58), 58.90 (1.03-2477.81), dan 110.23 (0.90-4150.58) RU/mL. Median (rentang) skor DAS28 pada keseluruhan subjek ditemukan 5.04 (4.04-7.10). Uji korelasi Spearman didapatkan korelasi positif lemah namun tidak bermakna secara statistik antara kadar anti-CCP serum dan DAS28 dengan rs = 0.296, p = 0.056, korelasi positif lemah yang bermakna secara statistik antara anti- CCP cairan sendi dan DAS28 dengan rs = 0.331, p = 0.037, sedangkan korelasi antara anti-CCP serum dengan cairan sendi ditemukan kuat yang bermakna secara statistik dengan rs = 0.907, p <0.01. Kami menyimpulkan kadar anti-CCP cairan sendi berkorelasi lemah dengan aktivitas penyakit (DAS28). Tidak ditemukan korelasi yang bermakna secara statistik antara kadar anti-CCP serum dengan aktivitas penyakit (DAS28). Terdapat korelasi kuat antara kadar anti-CCP serum dengan kadar anti-CCP dalam cairan sendi.

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Rheumatoid arhtritis is the most common chronic systemic autoimmune disease worldwide among many populations and races, characterized by persistent joint inflammation affecting peripheral joints, symmetrical distribution, with or without joint damage or bone erosion. Disease activity monitoring is needed to determine treatment response. Nowadays, Disease Activity Score 28 (DAS28) is used to monitor disease activity, although it uses subjective clinical parameter, complicated calculation, and ununiformity cut-off value for disease activity stages on various researches.

This study was a cross sectional study to assess wheter there was any correlation between anti-CCP serum and synovial fluid concentration with disease activity (DAS28) in 30 rheumatoid arhtritis subject. Blood and synovial fluid specimen collection and DAS28 determination was performed on subjects who fulfill inclusion and exclusion criteria, followed by anti-CCP assay on each specimen.

Median (range) anti-CCP serum concentration in overall, moderate, and severe disease activity were 112.23 (1.02-1853.07), 70.98 (1.02-1224.07), and 157.59 (1.07-1853.07) RU/mL, respectively. Median (range) anti-CCP synovial fluid concentration in overall, moderate, and severe disease activity were 85.54 (0.90-4150.58), 58.90 (1.03-2477.81), and 110.23 (0.90-4150.58) RU/mL, respectively. Median (range) of DAS28 were 5.04 (4.04-7.10). A weak but not statistically significant correlation was found between serum anti-CCP concentration and DAS28 with rs = 0.296 (p = 0.056). A weak and significant correlation was found between synovial fluid anti-CCP concentration and DAS28 with rs = 0.331 (p = 0.037). A strong and significant correlation are found between serum and synovial fluid anti-CCP concentration, with rs = 0.907 (p <0.01) using Spearman correlation test.

We concluded that synovial fluid anti-CCP concentration weakly correlated with disease activity. No significant correlation was found between serum anti-CCP concentration with disease activity. Strong correlation was found between serum and synovial fluid anti-CCP concentration."