Clinical Information

Rheumatoid factors (RF) are a heterogeneous group of autoantibodies associated with the diagnosis of rheumatoid arthritis (RA) but can also be found in other inflammatory rheumatic and nonrheumatic conditions. They can also be detected in some healthy individuals aged 60 years and older. Despite being nonspecific, the detection of RF or anti-citrullinated protein (anti-CCP) antibody is part of the 2010 diagnosis criterion of the American College of Rheumatology for classification of RA. More than 75% of patients with RA have an IgM antibody to IgG. The titer of RF correlates poorly with disease activity, but those patients with high titers tend to have more severe disease and, thus, a poorer prognosis than seronegative patients.

A meta-analysis compared the sensitivity and specificity of IgM RF versus anti-CCP antibody. For IgM RF, the sensitivity was 69% (CI, 65%-73%) and specificity was 85% (CI, 82%-88%). For comparison, the sensitivity for anti-CCP antibody was 67% (95% CI, 62%-72%) and 95% (CI, 94%-97%).(1) Both anti-CCP and RF are useful in the diagnosis of RA, and the use of both tests has been shown to increase diagnostic sensitivity.(2)