Anti-CCP in women: rheumatoid arthritis, joint symptoms and the blood test
Anti-CCP antibodies are aimed, according to the NVKC, at the body's own proteins rich in citrulline, and the immune system makes them in rheumatoid arthritis. According to Thuisarts, in rheumatoid arthritis the body makes antibodies against itself, and these settle in the joints, where they cause inflammation.
In almost all cases, according to the NVKC, a detected anti-CCP points to rheumatoid arthritis that is already present or has yet to develop. Only a blood test shows anti-CCP.
Certe uses 0 to 10 [arb'U]/mL for anti-CCP and Diagnostiek voor U below 5 U/mL.
Doctor's Assessment Included
Anti-CCP are antibodies against the body's own proteins containing citrulline, and according to the NHG these antibodies are associated with rheumatoid arthritis. According to the NVKC, a detected anti-CCP means in almost all cases that the patient has or will develop rheumatoid arthritis.
- Star-SHL calls an anti-CCP below 7 IU/ml negative and above 10 IU/ml positive; Unilabs uses below 7 kU/l, Certe 0 to 10 [arb'U]/mL and Diagnostiek voor U below 5 U/mL.
- According to the NHG, half of patients with rheumatoid arthritis have no anti-CCP, and the NHG therefore calls the test unsuitable as a screening instrument.
- According to the NVKC, anti-CCP can be detectable for some years before rheumatic symptoms arise.
Anti-CCP: what Dutch laboratories use
There is no nationally agreed reference value; this is what individual laboratories publish.
| Laboratory | Group | Reference value (IU/ml) | Relative scale |
|---|---|---|---|
| Star-shl | · Everyone · a limit, not a range · negative | < 7 IU/ml |
7
|
| Star-shl | · Everyone · doubtful | 7–10 IU/ml |
7 10
|
| Star-shl | · Everyone · a limit, not a range · positive | > 10 IU/ml |
10
|
| Unilabs | · Everyone · a limit, not a range | < 7 kU/l kU/l | |
| Certe | · Everyone | 0–10 [arb'U]/mL [arb'U]/mL | |
| Diagnostiek voor U | · Everyone · a limit, not a range | < 5 U/mL U/mL |
Source: Star-shl
Source: Unilabs
Source: Certe
Source: Diagnostiek voor U
Each value as the laboratory itself publishes it, retrieved in 2026.
Anti-CCP: what this test measures
According to the NVKC, the anti-CCP test measures whether and how many antibodies against the protein CCP are present in the blood. Certe has the test performed by the Medical Immunology laboratory of the UMCG.
Anti-CCP: why this value matters
According to the NVKC, anti-CCP helps to establish rheumatoid arthritis early, and when the symptoms are not yet very clear, the test can give extra information so that targeted treatment can begin earlier.
Anti-CCP: how the blood test works
- Referral
- No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
- The draw
- A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
- Where
- 650+ draw sites run by independent laboratories across the Netherlands. Draw sites
Anti-CCP: when is testing worthwhile?
According to the NVKC, an anti-CCP test is used as an aid in diagnosing rheumatoid arthritis, a disease in which according to Thuisarts joints become inflamed, swollen and painful, for example in the hands, wrists, feet or ankles. According to Thuisarts, the stiffness in rheumatoid arthritis is worst in the morning on getting up, or on starting to move again after sitting or lying for a while, and can last a few hours.
Anti-CCP: symptoms of a high or low value
Low Levels
According to the NVKC, with a negative anti-CCP the blood contains no antibodies against CCP, although the patient may still have rheumatoid arthritis. According to the NHG, half of patients with rheumatoid arthritis have no anti-CCP.
High Levels
According to the NVKC, a positive anti-CCP can be detectable in the blood for some years before rheumatic symptoms arise. According to Thuisarts, rheumatoid arthritis can also lead to anaemia, and according to Thuisarts the risk of heart and blood vessel disease is higher.
Anti-CCP: causes of a low or high value
What raises the value
-
Rheumatoid arthritis
Detected anti-CCP means in almost all cases that the patient has or will develop rheumatoid arthritis.
-
Rheumatoid arthritis that has yet to develop
Anti-CCP can be detectable for some years before rheumatic symptoms arise.
Anti-CCP: lifestyle and this value
With a positive anti-CCP, see your GP, who according to the NHG refers to the rheumatologist at short notice when rheumatoid arthritis is suspected. According to Thuisarts, smoking often makes rheumatoid arthritis worse, so that someone with rheumatoid arthritis can get more symptoms and more damage to the joints.
Anti-CCP: frequently asked questions
Is rheumatoid arthritis more common in women?
Yes, rheumatoid arthritis, the condition the anti-CCP test helps to establish according to the NVKC, has a male-to-female ratio of about 1:3 up to age 45, according to the NHG. According to the NHG, after age 45 the difference between men and women in rheumatoid arthritis decreases.
Anti-CCP: sources
- Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
- Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
- Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
- Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
- NVKC, Alles over testen: Anti-CCP, allesovertesten.nl, geraadpleegd 2026-10-15 (retrieved 2026) allesovertesten.nl
See Lunarahealth more often in Google
Add us as a preferred source. Google will then show our articles more often in your search results and in AI overviews. You can turn this off again at any time.
That did not work. Please try again.
Medical reviewer
Medical standards
Dr. Naimi oversees the medical standards behind our content and assessments.
Medical policy
Welzijn en Sport Official BIG registration BIG 49928676701 Opens in a new tab
Doctor's Assessment Included
Every result includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
Anti-CCP
€52,-