Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital

A multicentre study to improve clinical interpretation of proteinase-3 and myeloperoxidase anti-neutrophil cytoplasmic antibodies

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Comparison of treatment retention and response to secukinumab versus tumour necrosis factor inhibitors in psoriatic arthritis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. The impact of seropositivity on the effectiveness of biologic anti-rheumatic agents: results from a collaboration of 16 registries

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Long-Term Cardiovascular Outcomes in Systemic Lupus Erythematosus

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Influence of low socioeconomic status on mortality in granulomatosis with polyangiitis

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Association Between Long-Term Prednisolone Induced Adrenal Insufficiency and Polymorphisms in the Glucocorticoid Receptor Gene

    Research output: Contribution to journalConference abstract in journalResearchpeer-review

  4. Immunsystemet og den Medicinske Patient

    Research output: Chapter in Book/Report/Conference proceedingBook chapterCommunication

  • Xavier Bossuyt
  • Niels Rasmussen
  • Pieter van Paassen
  • Bernard Hellmich
  • Bo Baslund
  • Pieter Vermeersch
  • Daniel Blockmans
  • Jan-Willem Cohen Tervaert
  • Elena Csernok
  • Jan Damoiseaux
View graph of relations

Objective: The objective of this multicentre study was to improve the clinical interpretation of PR3- and MPO-ANCAs as an adjunct for the diagnosis of ANCA-associated vasculitis (AAV) by defining thresholds and test result intervals based on predefined specificities and by calculating test result interval-specific likelihood ratios (LRs).

Methods: Eight different PR3- and MPO-ANCA immunoassays from seven companies were evaluated using 251 diagnostic samples from AAV patients and 924 diseased controls.

Results: Thresholds for antibody levels were determined based on predefined specificities (95, 97.5, 99 and 100%) and used to delimit test result intervals. Test result interval-specific LRs were determined. For all assays, the LR for AAV increased with increasing antibody level. For all but one immunoassay, high antibodies levels (associated with LR >55) were found in a substantial fraction (>65%) of patients. The area under the curve (AUC) of receiver operating characteristics analysis of a diagnostic approach in which positive results were confirmed by IIF or another immunoassay was not substantially higher than the AUC of performing immunoassay only. The highest AUC was found when immunoassay was combined with another immunoassay or with IIF.

Conclusion: To diagnose AAV based on PR3- and MPO-ANCA, it is useful to define thresholds for antibody levels and to assign test result interval-specific LRs. Higher antibody levels are associated with a higher likelihood for disease. Such information improves clinical interpretation.

Original languageEnglish
JournalRheumatology (Oxford, England)
Issue number9
Pages (from-to)1533-1541
Number of pages9
Publication statusPublished - 1 Sep 2017

    Research areas

  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, Antibodies, Antineutrophil Cytoplasmic, Biomarkers, Case-Control Studies, Humans, Immunoassay, Likelihood Functions, Myeloblastin, Peroxidase, Sensitivity and Specificity, Comparative Study, Journal Article, Multicenter Study

ID: 52381903