title: Anti-MCV antibodies predict radiographic progression in Greek patients with very early (<3 months duration) rheumatoid arthritis.
abstract: This study aimed to assess the diagnostic and prognostic value of anti-mutated citrullinated vimentin (MCV) antibodies in very early rheumatoid arthritis (VERA) and in established rheumatoid arthritis (RA). Seventy-one patients with undifferentiated arthritis (UA) of <3 months duration, 141 with established RA, 53 with other rheumatic diseases, and 40 healthy individuals were included in the study. Anti-MCV, anti-cyclic citrullinated peptide (CCP) antibodies, and rheumatoid factor (RF) were determined and hand radiographs were recorded. Patients were assessed prospectively for 2 years, and hand radiographs were repeated. Diagnostic performance of anti-MCV was studied with receiver operating characteristic (ROC) curves and evaluation of sensitivity, specificity, and likelihood ratios. Forty-six percent of UA patients progressed to RA at 2 years. In VERA patients, sensitivity of anti-MCV was 52 %, compared to 44 % of anti-CCP and 37 % of RF, while specificity was 91 %, compared to 91 % of RF and 84 % of anti-CCP. Anti-MCV were detected in 25 % of VERA patients negative for both anti-CCP and RF. In established RA, anti-MCV did not sustain its diagnostic performance. By multivariable analysis, anti-MCV, but not anti-CCP or RF, showed significant correlation with radiographic progression in VERA patients. In established RA, anti-MCV, anti-CCP, and RF were associated with active disease (p ≤ 0.03) and joint damage (p ≤ 0.004). By multivariate analysis, the strongest factors for radiographic damage were disease duration (p = 0.000), HAQ score (p = 0.000), and RF (p = 0.002). In conclusion, in patients with very early UA, anti-MCV predict both progression to RA and radiological damage, and therefore, anti-MCV antibody testing may be useful in every day practice.
authors.affiliation: Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Thessaly and University General Hospital of Larissa, Biopolis, 41 110, Larissa, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Barouta
authors.affiliation: Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Thessaly and University General Hospital of Larissa, Biopolis, 41 110, Larissa, Greece.
authors.forename: Christina G
authors.initials: CG
authors.lastname: Katsiari
authors.affiliation: Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Thessaly and University General Hospital of Larissa, Biopolis, 41 110, Larissa, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Alexiou
authors.affiliation: Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Thessaly and University General Hospital of Larissa, Biopolis, 41 110, Larissa, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Liaskos
authors.affiliation: Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Thessaly and University General Hospital of Larissa, Biopolis, 41 110, Larissa, Greece.
authors.forename: Areti
authors.initials: A
authors.lastname: Varna
authors.affiliation: Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Thessaly and University General Hospital of Larissa, Biopolis, 41 110, Larissa, Greece.
authors.forename: Dimitrios P
authors.initials: DP
authors.lastname: Bogdanos
authors.affiliation: Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly and University General Hospital of Larissa, Larissa, Greece.
authors.forename: Anastasios E
authors.initials: AE
authors.lastname: Germenis
authors.affiliation: Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Thessaly and University General Hospital of Larissa, Biopolis, 41 110, Larissa, Greece. lsakkas@med.uth.gr.
authors.forename: Lazaros I
authors.initials: LI
authors.lastname: Sakkas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000473:pathology; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006115:Greece; D006225:Hand / Q000000981:diagnostic imaging / Q000502:physiology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000276:immunology*; D011379:Prognosis; D012372:ROC Curve; D011859:Radiography; D012217:Rheumatoid Factor / Q000097:blood; D012680:Sensitivity and Specificity; D014746:Vimentin / Q000276:immunology*; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D010456:Peptides, Cyclic; D014746:Vimentin; D012217:Rheumatoid Factor
keywords: Anti-CCP antibodies; Anti-vimentin antibodies; Radiographic progression; Rheumatoid factor; Very early rheumatoid arthritis