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Value of anti-modified citrullinated vimentin and third-generation anti-cyclic citrullinated peptide compared with second-generation anti-cyclic citrullinated peptide and rheumatoid factor in predicting disease outcome in undifferentiated arthritis and rheumatoid arthritis.
Arthritis Rheum 2009; 60(8):2232-41AR

Abstract

OBJECTIVE

Autoantibodies such as rheumatoid factor (RF) and anti-citrullinated protein autoantibodies (ACPAs) determined by testing with second-generation anti-cyclic citrullinated peptide (anti-CCP-2) are frequently measured in clinical practice because of their association with disease outcome in undifferentiated arthritis (UA) and rheumatoid arthritis (RA). Recently, 2 new ACPA tests were developed: third-generation anti-CCP (anti-CCP-3) and anti-modified citrullinated vimentin (anti-MCV) autoantibody tests. To facilitate the decision on which autoantibody to test in daily practice, this study evaluated the capability of these autoantibodies and combinations of them to predict 3 outcome measures: progression from UA to RA, the rate of joint destruction in RA, and the chance of achieving sustained disease-modifying antirheumatic drug (DMARD)-free remission in RA.

METHODS

Patients with UA (n=625) were studied for whether UA progressed to RA after 1 year. Patients with RA (n=687) were studied for whether sustained DMARD-free remission was achieved and for the rate of joint destruction during a median followup of 5 years. Positive predictive values (PPVs) for RA development and for associations with the disease course in RA were compared between single tests (anti-CCP-2, anti-CCP-3, anti-MCV, and RF) and between combinations of these tests.

RESULTS

Among the single tests performed in patients with UA, anti-CCP-2 tended to have the highest PPV for RA development (67.1%), but the 95% confidence intervals of the other tests overlapped. Among the single tests in patients with RA, all 4 tests showed comparable associations with the rate of joint destruction and with the achievement of remission. In both ACPA-positive and ACPA-negative RA, the presence of RF was not associated with more joint destruction. For all outcome measures, performing combinations of 2 or 3 autoantibody tests did not increase the predictive accuracy compared with performing a single test.

CONCLUSION

For clinical practice, a single autoantibody test is sufficient for risk estimation in UA and RA.

Authors+Show Affiliations

Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. M.P.M.van_der_Linden@lumc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19644872

Citation

van der Linden, Michael P M., et al. "Value of Anti-modified Citrullinated Vimentin and Third-generation Anti-cyclic Citrullinated Peptide Compared With Second-generation Anti-cyclic Citrullinated Peptide and Rheumatoid Factor in Predicting Disease Outcome in Undifferentiated Arthritis and Rheumatoid Arthritis." Arthritis and Rheumatism, vol. 60, no. 8, 2009, pp. 2232-41.
van der Linden MP, van der Woude D, Ioan-Facsinay A, et al. Value of anti-modified citrullinated vimentin and third-generation anti-cyclic citrullinated peptide compared with second-generation anti-cyclic citrullinated peptide and rheumatoid factor in predicting disease outcome in undifferentiated arthritis and rheumatoid arthritis. Arthritis Rheum. 2009;60(8):2232-41.
van der Linden, M. P., van der Woude, D., Ioan-Facsinay, A., Levarht, E. W., Stoeken-Rijsbergen, G., Huizinga, T. W., ... van der Helm-van Mil, A. H. (2009). Value of anti-modified citrullinated vimentin and third-generation anti-cyclic citrullinated peptide compared with second-generation anti-cyclic citrullinated peptide and rheumatoid factor in predicting disease outcome in undifferentiated arthritis and rheumatoid arthritis. Arthritis and Rheumatism, 60(8), pp. 2232-41. doi:10.1002/art.24716.
van der Linden MP, et al. Value of Anti-modified Citrullinated Vimentin and Third-generation Anti-cyclic Citrullinated Peptide Compared With Second-generation Anti-cyclic Citrullinated Peptide and Rheumatoid Factor in Predicting Disease Outcome in Undifferentiated Arthritis and Rheumatoid Arthritis. Arthritis Rheum. 2009;60(8):2232-41. PubMed PMID: 19644872.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Value of anti-modified citrullinated vimentin and third-generation anti-cyclic citrullinated peptide compared with second-generation anti-cyclic citrullinated peptide and rheumatoid factor in predicting disease outcome in undifferentiated arthritis and rheumatoid arthritis. AU - van der Linden,Michael P M, AU - van der Woude,Diane, AU - Ioan-Facsinay,Andreea, AU - Levarht,E W Nivine, AU - Stoeken-Rijsbergen,Gerrie, AU - Huizinga,Tom W J, AU - Toes,René E M, AU - van der Helm-van Mil,Annette H M, PY - 2009/8/1/entrez PY - 2009/8/1/pubmed PY - 2009/9/26/medline SP - 2232 EP - 41 JF - Arthritis and rheumatism JO - Arthritis Rheum. VL - 60 IS - 8 N2 - OBJECTIVE: Autoantibodies such as rheumatoid factor (RF) and anti-citrullinated protein autoantibodies (ACPAs) determined by testing with second-generation anti-cyclic citrullinated peptide (anti-CCP-2) are frequently measured in clinical practice because of their association with disease outcome in undifferentiated arthritis (UA) and rheumatoid arthritis (RA). Recently, 2 new ACPA tests were developed: third-generation anti-CCP (anti-CCP-3) and anti-modified citrullinated vimentin (anti-MCV) autoantibody tests. To facilitate the decision on which autoantibody to test in daily practice, this study evaluated the capability of these autoantibodies and combinations of them to predict 3 outcome measures: progression from UA to RA, the rate of joint destruction in RA, and the chance of achieving sustained disease-modifying antirheumatic drug (DMARD)-free remission in RA. METHODS: Patients with UA (n=625) were studied for whether UA progressed to RA after 1 year. Patients with RA (n=687) were studied for whether sustained DMARD-free remission was achieved and for the rate of joint destruction during a median followup of 5 years. Positive predictive values (PPVs) for RA development and for associations with the disease course in RA were compared between single tests (anti-CCP-2, anti-CCP-3, anti-MCV, and RF) and between combinations of these tests. RESULTS: Among the single tests performed in patients with UA, anti-CCP-2 tended to have the highest PPV for RA development (67.1%), but the 95% confidence intervals of the other tests overlapped. Among the single tests in patients with RA, all 4 tests showed comparable associations with the rate of joint destruction and with the achievement of remission. In both ACPA-positive and ACPA-negative RA, the presence of RF was not associated with more joint destruction. For all outcome measures, performing combinations of 2 or 3 autoantibody tests did not increase the predictive accuracy compared with performing a single test. CONCLUSION: For clinical practice, a single autoantibody test is sufficient for risk estimation in UA and RA. SN - 0004-3591 UR - https://www.unboundmedicine.com/medline/citation/19644872/Value_of_anti_modified_citrullinated_vimentin_and_third_generation_anti_cyclic_citrullinated_peptide_compared_with_second_generation_anti_cyclic_citrullinated_peptide_and_rheumatoid_factor_in_predicting_disease_outcome_in_undifferentiated_arthritis_and_rheumatoid_arthritis_ L2 - https://doi.org/10.1002/art.24716 DB - PRIME DP - Unbound Medicine ER -