Research article

Antibodies to mutated citrullinated vimentin and disease activity score in early arthritis: a cohort study

Jennie Ursum¹ , Markus MJ Nielen¹ , Dirkjan van Schaardenburg^1,2 , Ann R van der Horst³ , Rob J van de Stadt¹ , Ben AC Dijkmans² and Dörte Hamann³

¹  Jan van Breemen Institute, Dr Jan van Breemenstraat, 1056 AB Amsterdam, The Netherlands

²  VU University Medical Centre, 1007 MB Amsterdam, The Netherlands

³  Sanquin Diagnostic Services, 1006 AD Amsterdam, The Netherlands

author email corresponding author email

Arthritis Research & Therapy 2008, 10:R12doi:10.1186/ar2362

Published:	28 January 2008

Abstract

Introduction

The aim of our study was to investigate the association between arthritic disease activity and antibodies to mutated citrullinated vimentin (anti-MCV), because such a relation has been suggested.

Methods

Anti-MCV levels were measured in 162 patients with early arthritis (123 with rheumatoid arthritis and 39 with undifferentiated arthritis) at baseline and at 1 and 2 years of follow up. Disease activity was measured using the disease activity score (Disease Activity Score based on 28 joints [DAS28]) and serum C-reactive protein. General estimation equation analysis was used to assess the relation between anti-MCV levels and DAS28 over time.

Results

Both, anti-MCV levels and DAS28 exhibited a significant decrease during the first and second year. However, the association between anti-MCV levels and DAS28, adjusted for dependency on sequential measurements within one individual, was very low (β = 0.00075). In a population of patients with rheumatoid arthritis or undifferentiated arthritis, anti-MCV had a specificity of 92.3% and a sensitivity of 59.3% when using the recommended cut-off of 20 U/ml. Specificity and sensitivity of antibodies against second-generation cyclic citrullinated peptide, using the recommended cut-off value of 25 U/ml, were 92.1% and 55.3%, respectively. Anti-MCV-positive early arthritis patients had significantly higher Sharp-van der Heijde score, erythrocyte sedimentation rate and C-reactive protein levels than did anti-MCV-negative patients at all time points (P < 0.005), but DAS28 was higher in anti-MCV-positive patients at 2 years of follow up only (P < 0.05).

Conclusion

Because the correlation between anti-MCV levels and parameters of disease activity was very low, we conclude that it is not useful to monitor disease activity with anti-MCV levels.