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We agree with the notions made by Infantino et al 1 in their reply to our previously published report2 concerning the need for multicentre studies to obtain large enough number to validate new methods for detection of myositis-specific antibodies (MSA) and myositis-associated autoantibodies (MAA). We also agree with the suggestion to evaluate the possibility to individualise reference ranges (cut-off values) for the individual autoantibodies in multi-autoantibody assays like line immune assays (LIA). In relation to such proposals, we would like to stress our experience that the same LIA might yield very quantitatively divergent results in different laboratories, for example, due to differences in laboratory temperature3 but certainly also other factors, and that these quantitative differences may result in qualitatively divergent results. One way to help standardisation of laboratory results might be to include quantitative internal controls for the individual autoantibodies included in the LIAs, as we have discussed before.4 Multicentre studies on the evaluation of LIAs or other methods for detection of MSA and MAA should preferably be combined with use of such common internal controls in the participating laboratories.
Handling editor Josef S Smolen
Contributors All authors have equally contributed.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.