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Ann Rheum Dis. Published Online First: 20 October 2009. doi:10.1136/ard.2009.118448
Copyright © 2009 BMJ Publishing Group Ltd & European League Against Rheumatism.

letter

Letter

Anti-modified citrullinated vimentin (MCV) antibodies in patients with very early synovitis

Karim Raza1,*, Linda Mathsson2, Christopher D Buckley1, Andrew Filer1, Johan Rönnelid2

1 University of Birmingham, United Kingdom;
2 Uppsala University, Sweden

Correspondence to: Karim Raza, Division of Immunity and Infection, University of Birmingham, Rheumatology Research Group, Division of Immunity and Infection, University of Birmingham, Birmingham, B15 2TT, United Kingdom; k.raza{at}bham.ac.uk

Accepted 17 September 2009

ABSTRACT

Anti-CCP antibodies are very specific for the development of RA in patients with very early synovitis.[1] Their predictive value is underscored by their high weighting in an algorithm validated in patients with undifferentiated synovitis ≤ 3 months duration.[2] However, using this algorithm, one cannot accurately predict outcome in 25% of patients and additional predictive markers are needed. We have reported that antibodies against type II collagen were unhelpful in this phase of disease.[3] Several groups have measured anti-modified citrullinated vimentin (MCV) antibodies in RA patients. In patients with symptoms of < 12 months’ duration, the specificity and sensitivity of anti-MCV were 95% and 71% respectively.[4] The enhanced sensitivity, compared with anti-CCP2, raised the possibility of clinical utility. Subsequently, in patients with synovitis of < 2 years duration, a specificity and sensitivity of 83% and 62% (vs 93% and 57% for anti-CCP2 respectively) has been reported [5].


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