Antibodies to mutated citrullinated vimentin and disease activity score in early arthritis: a cohort studyReportar como inadecuado

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Arthritis Research and Therapy

, 10:R12

First Online: 28 January 2008Received: 09 October 2007Revised: 20 December 2007Accepted: 28 January 2008


IntroductionThe aim of our study was to investigate the association between arthritic disease activity and antibodies to mutated citrullinated vimentin anti-MCV, because such a relation has been suggested.

MethodsAnti-MCV levels were measured in 162 patients with early arthritis 123 with rheumatoid arthritis and 39 with undifferentiated arthritis at baseline and at 1 and 2 years of follow up. Disease activity was measured using the disease activity score Disease Activity Score based on 28 joints DAS28 and serum C-reactive protein. General estimation equation analysis was used to assess the relation between anti-MCV levels and DAS28 over time.

ResultsBoth, anti-MCV levels and DAS28 exhibited a significant decrease during the first and second year. However, the association between anti-MCV levels and DAS28, adjusted for dependency on sequential measurements within one individual, was very low β = 0.00075. In a population of patients with rheumatoid arthritis or undifferentiated arthritis, anti-MCV had a specificity of 92.3% and a sensitivity of 59.3% when using the recommended cut-off of 20 U-ml. Specificity and sensitivity of antibodies against second-generation cyclic citrullinated peptide, using the recommended cut-off value of 25 U-ml, were 92.1% and 55.3%, respectively. Anti-MCV-positive early arthritis patients had significantly higher Sharp-van der Heijde score, erythrocyte sedimentation rate and C-reactive protein levels than did anti-MCV-negative patients at all time points P < 0.005, but DAS28 was higher in anti-MCV-positive patients at 2 years of follow up only P < 0.05.

ConclusionBecause the correlation between anti-MCV levels and parameters of disease activity was very low, we conclude that it is not useful to monitor disease activity with anti-MCV levels.

AbbreviationsACPA= antibody to citrullinated protein-peptide antigens

CCP2= second-generation cyclic citrullinated peptide

CRP= C-reactive protein

DAS28= Disease Activity Score based on 28 joints

ELISA= enzyme-linked immunosorbent assay

ESR= erythrocyte sedimentation rate

GEE= general estimation equation

MCV= mutated citrullinated vimentin

RA= rheumatoid arthritis

SHS= Sharp-van der Heijde score

UA= undifferentiated arthritis

VAS= visual-analogue scale.

Electronic supplementary materialThe online version of this article doi:10.1186-ar2362 contains supplementary material, which is available to authorized users.

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Autor: Jennie Ursum - Markus MJ Nielen - Dirkjan van Schaardenburg - Ann R van der Horst - Rob J van de Stadt - Ben AC Dijkmans


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