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( 5) About 60 to 80 percent of people with RA have these so-called anti-CCPs, and these antibodies can show up years before symptoms develop, according to the Arthritis Foundation. Compared with RF, anti-CCP is a more specific marker of the disease and high levels of anti-CCP antibodies may indicate a greater RA severity. (4) In recent years, researchers have identified a number of different ACPAs, detected through the anti-CCP tests. A study published in June 2018 in the journal Annals of the Rheumatic Diseases found that no single ACPA is responsible for RA joint damage and inflammation. Rather, having a number of different ACPAs is associated with a number of markers of joint destruction and inflammation, according to the study. This suggests that the anti-CCP tests may be able to help clinicians determine who will develop greater joint damage. ( 6) Though RF and anti-CCP antibody tests are highly informative and can help with diagnoses, they're not enough to diagnose RA alone. Up to half of patients don't have both RF and anti-CCP antibodies when initially tested, and 20 percent of people who are found to have RA never test positive for the antibodies.