Anti-CCP antibodies
Autoantibodies against citrullinated peptides, a lab marker for rheumatoid arthritis
Also known as
Definition
CCP antibodies (antibodies against cyclic citrullinated peptides, ACPA) are autoantibodies: immune system proteins that mistakenly target the body's own tissue, mainly tissue in the joints. Most people with rheumatoid arthritis have them in their blood, while people without the disease almost never do. They are usually measured together with or after rheumatoid factor.
| Parameter | Value |
|---|---|
| Unit | positive or negative; value and unit depend on the assay |
| Reference Range | Negative: no CCP antibodies detected, or a value below the lab's cut-off. Cut-offs differ between assays; the range on your own report is what counts. Discuss your result with your doctor. |
Agree on your personal target range with your doctor.
↓ What a low value means
A negative result means no CCP antibodies were found. If rheumatoid factor is also negative, rheumatoid arthritis is less likely but not ruled out. With ongoing joint symptoms, further tests may be needed to find the cause; your doctor decides on these.
↑ What a high value means
A positive result means CCP antibodies are detectable in the blood. With matching symptoms and a positive rheumatoid factor, this may point to rheumatoid arthritis. If only the CCP test is positive, this may be related to an early stage of the disease or to developing it later. CCP antibodies occasionally also occur with other autoimmune diseases such as Sjögren's syndrome or lupus, with active tuberculosis or with chronic lung disease. Your doctor makes the diagnosis based on symptoms, examination and other findings.
When to test
The test is considered with joint pain, joint swelling or joint stiffness, especially in the morning, often together with fatigue or a low-grade fever, and when other tests could neither confirm nor rule out rheumatoid arthritis. Tell your practice about all medicines and supplements beforehand; some may need to be paused for 8 hours before the blood draw, but only as instructed by your practice.
Frequently asked questions
How do CCP antibodies differ from rheumatoid factor? +
Both are autoantibodies. Rheumatoid factor also occurs with other autoimmune diseases and in some healthy people, and some people with rheumatoid arthritis have little rheumatoid factor. CCP antibodies almost never occur in people without rheumatoid arthritis. Measured together, both tests give a more accurate picture than rheumatoid factor alone.
Does a negative CCP test rule out rheumatoid arthritis? +
No. A negative result makes the disease less likely, especially if rheumatoid factor is negative too. Symptoms, physical examination and other findings also count for the assessment.
Which tests complement the CCP test? +
X-rays of the joints and blood tests such as erythrocyte sedimentation rate (ESR), CRP and antinuclear antibodies (ANA) are often added, sometimes also an analysis of joint fluid. Your doctor decides which of these make sense.
Anti-CCP antibodies
Last updated: October 05, 2026
This information is for orientation only and does not replace medical advice. Reference ranges can vary by laboratory, method and country.