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