Objective: To review the diagnostic and prognostic value of anti-MCV in rheumatoid arthritis taken into account the already available serology.
Methods: Medline was searched through Pubmed (1966- May 2008) for anti-MCV and related terms, arthritis and arthropathies. Studies with anti-MCV, arthritis/arthropathy, and primary data on diagnosis and/or prognosis were included. Their methodological quality was assessed using the QUADAS for diagnostic studies and the modified Hayden list for prognostic studies.
Results: Of 14 eligible studies, 11 included diagnostic data and 3 included prognostic data. No study evaluated anti-MCV as added diagnostic test to the already available anti-CCP and rheumatoid factor serology. One study included the optimal patient spectrum resulting in sensitivity of 0.59 and specificity of 0.98. Ten diagnostic case-control studies using the same anti-MCV kit showed a sensitivity of 0.64-0.84 and a specificity of 0.79-0.96. This almost equalled the performance of anti-CCP in the same studies. The prognostic evaluation of anti-MCV was limited by differences in study methodology, outcome and statistical modelling. Individual studies showed moderate associations for anti-MCV and radiological progression with the strength of the association comparable to that of anti-CCP.
Conclusion: Study heterogeneity, choice of study population and methodological limitations limited overall conclusions about the true diagnostic and prognostic test performance of anti-MCV. Evidence from the diagnostic case-control studies suggests that anti-MCV may be used as an alternative for anti-CCP.
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