Diagnostic value of antibodies to modified citrullinated vimentin in early rheumatoid arthritis.

The aim of this study was to evaluate the usefulness of antibodies to modified citrullinated vimentin (anti-MCV) for diagnosing early rheumatoid arthritis (RA) and to examine the correlations between anti-MCV and clinical parameters as well as radiographic and ultrasound data. Our results suggest that anti-MCV has a sensitivity and specificity of 53.3 and 83.3%, respectively, and a positive prognostic value of 96% in patients with early RA. Anti-MCV antibodies were observed in 48.5% of rheumatoid factor (RF)-negative RA patients in data from a latex test and in 35.7% of patients with negative results for immunoglobulin (Ig)-M-RF. The positive result for both anti-MCV and IgM-RF has a sensitivity of 42.2% and a specificity of 100%. No significant correlation was observed between anti-MCV and disease activity score using 28 joint counts, radiographic RA stage, number of erosions on ultrasonography of joints, and quality-of-life scores at disease onset. The Spearman correlation was significant in early RA patients with positive results of anti-MCV between the titers of this marker and arthritis duration, level of erythrocyte sedimentation rate, and IgM-RF. The best diagnostic strategy in early RA may be to assay both anti-MCV and IgM-RF. Thus, a question arises regarding the possible inclusion of anti-MCV in future revisions of the classification criteria of RA.