REVIEW - Does anti-MCV have additional value as a serological marker for diagnosis and prognosis in RA?

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Ann Rheum Dis. 2009 Mar 15.

Does anti-MCV has additional value as serological marker in the

diagnostic and prognostic work-up of patients with rheumatoid

arthritis? A systematic review.

Luime JJ, Colin EM, Hazes JM, Lubberts E.

Erasmus Medical Centre, Netherlands.

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.

PMID: 19289382

http://www.ncbi.nlm.nih.gov/pubmed/19289382

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