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Anti-CCP IgG

Immunology & Autoimmune

Anti-CCPCCP antibodiesCyclic citrullinated peptide antibody

Review status

Currently under review

Pending specialist review and validation.

What it shows

The Anti-CCP IgG test measures IgG antibodies that target cyclic citrullinated peptides, proteins that have undergone a natural chemical change called citrullination. These antibodies are closely linked to rheumatoid arthritis and reflect an immune response directed against your own joint tissues.

This is a blood test performed in the laboratory. Anti-CCP antibodies can be present before joint symptoms fully develop, and they are used alongside your history, examination, imaging, and other blood tests to help clarify whether your symptoms are due to rheumatoid arthritis.

Why it matters

Results from the Anti-CCP IgG test help your clinician evaluate the likelihood of rheumatoid arthritis, especially in people with persistent joint pain, swelling, or morning stiffness. A positive result supports the diagnosis in the right clinical setting and can help distinguish rheumatoid arthritis from other causes of joint symptoms.

Anti-CCP status may also offer prognostic information, since people with these antibodies can have a higher chance of more persistent or erosive disease. Knowing this early can prompt timely referral to a rheumatologist and consideration of disease‑modifying therapy. The test is typically ordered with other tests such as rheumatoid factor, inflammatory markers, and imaging. Risks are limited to those of a routine blood draw.

Understanding your results

Your result is interpreted together with your symptoms, examination, imaging, and other lab findings. A positive Anti-CCP IgG increases the likelihood of rheumatoid arthritis, but it does not confirm the diagnosis by itself. A negative result does not rule out rheumatoid arthritis, particularly early in the disease or if you are already on immune‑modifying treatment.

Antibody levels can vary by laboratory method, so results from different labs are not always interchangeable. If your result is unexpected, your clinician may repeat testing, review other markers such as rheumatoid factor and inflammatory tests, or arrange imaging of your joints. If you are diagnosed with rheumatoid arthritis, treatment decisions will be based on your overall disease activity and health goals rather than this single result.

Reference ranges

05 RU/mL
All sexes
0 days – 150 years

Reference intervals vary by laboratory, analyzer, methodology, population, and units. The ranges shown here are for education only. Always interpret your results against the reference interval printed on your own lab report.

Factors that could impact Anti-CCP IgG

  • Assay differences

    Different laboratories use different generations and methods for Anti-CCP testing. Results may not be directly comparable across labs, so follow trends using the same laboratory when possible.

  • Smoking and gum disease

    Cigarette smoking and periodontal disease are linked to the development of Anti-CCP antibodies and may increase the chance of a positive result in people at risk for rheumatoid arthritis.

  • Medications and immune therapy

    Disease‑modifying antirheumatic drugs, steroids, and biologics can alter immune activity over time and may modestly change antibody levels. Treatment decisions should not rely on this test alone.

  • Sample handling and biotin

    Improper sample handling or high‑dose biotin supplements can interfere with some immunoassays. Tell your clinician about supplements and follow any instructions to pause high‑dose biotin before testing.

  • Other autoimmune or chronic conditions

    Although uncommon, certain autoimmune diseases or chronic inflammatory conditions may be associated with Anti-CCP positivity. Clinical context is essential for interpretation.

  • Pregnancy and special populations

    Immune changes in pregnancy and postpartum can affect autoantibody profiles. In children or older adults, interpretation should be tailored to symptoms and alternative diagnoses.

2026

References

  1. McGill University Health Centre. (2016, May 26). Anti-CCP IgG (Task CD 5046901). Laboratory reference ranges.
  2. Aletaha, D., Neogi, T., Silman, A. J., Funovits, J., Felson, D. T., Bingham, C. O., III, ... Hawker, G. (2010). 2010 rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism collaborative initiative. Annals of the Rheumatic Diseases, 69(9), 1580–1588.
  3. Fraenkel, L., Bathon, J. M., England, B. R., St. Clair, E. W., Arayssi, T., Carandang, K., ... Singh, J. A. (2021). 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis & Rheumatology, 73(7), 1108–1123.