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FRI0102 Comparison of Diagnostic Accuracies of Anti-MCV and Anti-CCP Antibodies in Rheumatoid Arthritis: A Meta-Analysis
  1. Y.H. Lee,
  2. G.G. Song
  1. Rheumatology, Korea University Medicial Center, Seoul, Korea, Republic Of

Abstract

Background Enhanced antibody reactivity against the mutated citrullinated vimentin (MCV) was found in the serum of RA patients compared to the citrullinated vimentin, and anti-MCV showed increased diagnostic accuracy. Anti-MCV has been studied in comparison to anti-cyclic citrullinated peptide (anti-CCP) with respect to diagnostic accuracy in rheumatoid arthritis (RA). However, it remains unclear if the overall diagnostic values of anti-MCV antibodies are comparable to anti-CCP antibodies.

Objectives The purpose of this study was to compare the diagnostic performance of anti-mutated citrullinated vimentin (anti-MCV) and anti-CCP antibodies in RA.

Methods We searched the Medline, Embase, and Cochrane library databases, and performed two meta-analyses on the diagnostic accuracy of anti-MCV and anti-CCP in patients with RA compared to healthy controls.

Results We identified 12 studies that included a total of 2,003 RA patients and 831 controls for the meta-analysis. The pooled sensitivity and specificity of anti-MCV were 68.6% (95% confidence interval [CI] 66.6–79.7) and 94.2% (95% CI 92.4–96.7), and those of anti-CCP were 61.7% (95% CI 59.5–63.8) and 97.1% (95% CI 96.7–98.1), respectively. Anti-MCV PLR, NLR, and DOR were 12.99 (95% CI 8.013–21.27), 0.297 (95% CI 0.238–0.369), and 47.78 (95% CI 28.59–79.84), and those for anti-CCP were 16.71 (95% CI 11.42–24.47), 0.378 (95% CI 0.325–0.439), and 54.20 (95% CI 31.65–92.82), respectively. The AUC of anti-MCV was 0.886, and its Q* index was 0.817, indicating modest accuracy, while the AUC of anti-CCP was 0.946, and its Q* index was 0.885. The sensitivity of anti-MCV was significantly higher than that of anti-CCP in the diagnosis of RA (difference 0.069, 95% CI 0.039–0.098, p<0.0001), but the specificity of anti-MCV was lower than that of anti-CCP (difference −0.029, 95% CI −0.051–[−0.006], p=0.012). The Q* index of anti-MCV was significantly lower than that of anti-CCP (difference −0.068, 95% CI −0.070–[−0.065], p<0.0001).

Conclusions Our meta-analysis demonstrates that anti-MCV is more sensitive but less specific, and has lower diagnostic accuracy than anti-CCP in RA, although anti-MCV and anti-CCP showed comparable high PLRs.

Disclosure of Interest None declared

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