Anti-mutated citrullinated vimentin antibody and rheumatoid factor (prevalence and association) in rheumatoid arthritis patients; Saudi and non-Saudi.

UNLABELLED: background: The aims of this study were to assess the prevalence of anti-mutated citrullinated vimentin (MCV) antibodies and rheumatoid factor (RF) and to evaluate their association in rheumatoid arthritis patients, both Saudi and non-Saudi. METHODS: Retrospectively, we studied 280 rheumatoid arthritis patients, at King Abdulaziz University Hospital. The antibodies were measured by enzyme linked immunosorbent assay and rheumatoid factor by nephelometry. RESULTS: The 280 patients included 196 Saudis and 84 non-Saudis, 88% females and 12% males, and the mean age was 45.3 years (SD = 14.3). Prevalence of rheumatoid factor was 141/280 (50%) divided as 93/196 (47.5%) Saudis and 48/84 (57%) non-Saudis, with no significant differences (p > 0.05). Prevalence of mutated citrullinated vimentin antibodies was 165/280 (58.2%) divided as 121/196 (61.7%) Saudis and 44/84 (52.4%) non-Saudis, with no significant differences (p > 0.05). Among RF -ve patients, considerable numbers were anti-MCV +ve, and vice versa. Also, among the anti-MCV -ve patients, considerable numbers were RF +ve, and vice versa. In all cohorts and in Saudi and non Saudi patients, anti-MCV positivity was significantly associated with RF positivity (odds ratio (OR) 3.15; 95% CI 1.9, 5.19/p = 0.000); ESR and CRP were high with significant correlation (p < 0.005) with each other, with RF positivity but not with anti-MC positivity. Anti-MC positivity showed no significant correlation with age and gender. CONCLUSIONS: In this cohort of patients, anti-MCV antibodies are a useful diagnostic tool for RA, but its combination with RF is essential. Both markers are significantly associated. Larger scale studies are recommended. Correlation of anti-MCV with treatment and with disease activity still has to be published.

Pattern of drugs use and association with anti-mutated citrullinated vimentin antibody in rheumatoid arthritis.

OBJECTIVES: To demonstrate the pattern of disease-modifying antirheumatic drugs (DMARDs) use in Saudi and non-Saudi rheumatoid arthritis (RA) patients, and to evaluate the association of DMARDs use with anti-mutated citrullinated vimentin (anti-MCV) positivity and other factors. METHODS: Retrospectively, for a period of 7 years (2007-2014), we studied 205 RA patients, at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. All patients used DMARDs. Pattern of use for all 6 DMARDs was almost the same among Saudis and non-Saudis with no significant difference (p>0.05) for each DMARD; MTX was the most commonly used DMARD (71-76%). RESULTS: There was no association between anti-MCV positivity and different DMARDs use. Methotrexate was used 76 times as combination, scoring the highest in this respect. There was a significant correlation (p<0.05) between Plaquenil with Methotrexate and with Sulfasalazine; Leflunomide with anti-TNF and with Prednisolone; age with Methotrexate and with Plaquenil; anti-MCV positivity with Prednisolone. Saudi/non-Saudi status showed no correlation with all factors or drugs. There was no significant association between DMARDs and comorbidity. CONCLUSION: Similar to worldwide results, MTX was the most commonly used DMARD; with the addition of anti-TNF to increase the effect, and folic acid to minimize the side effects. In this cohort, the pattern of use for all DMARDs was similar among Saudis and non-Saudis; treatment depended neither on anti-MCV positivity nor on the presence of comorbid conditions. A study of the association of DMARDs with disease activity is recommended.