Objectives: This study evaluates the diagnostic performance of the anti-CCP2, anti-CCP3 and anti-MCV tests in differentiating rheumatoid arthritis (RA) from other forms of arthritis in a clinical setting of early arthritis.
Methods: In 917 patients with recent-onset arthritis (566 RA, 351 other diseases) and in 99 healthy-controls the anti-MCV, anti-CCP2 and anti-CCP3.1 tests were performed and the test-characteristics compared.
Results: Comparing RA with other causes of arthritis revealed a lower specificity for anti-MCV (82.9%) than for anti-CCP2 (93.4%) and anti-CCP3.1 (90%). Similarly, the positive likelihood-ratio for anti-MCV was lower as well (3.6, compared to 8.7, 5,8 for anti-CCP2 and anti-CCP3.1). The anti-MCV test had a higher sensitivity (62% versus 56.9% and 58.1% respectively). In psoriatic-arthritis, ankylosing-spondylitis and other arthritis anti-MCV-antibodies had a prevalence of 15.2%, 13.9% and 19.4%.
Conclusion: The diagnostic performance of the anti-MCV test in the differential diagnosis of early arthritis is lower compared to the anti-CCP tests.