Sensitivity and Specificity of Autoantibodies Against CD74 in Early Axial Spondyloarthritis

Torsten Witte¹, Elke Riechers², Niklas Thomas Baerlecken³, Xenofon Baraliakos⁴, Katrin Achilles-Mehr Bakhsh⁵, Peer Aries⁶, Bettina Bannert⁷, Klaus Becker⁸, Jan Brandt-Juergens⁹, Juergen Braun¹⁰, Boris P. Ehrenstein¹¹, Hartwig Euler¹², Martin Fleck¹³, Reinhard Hein¹⁴, Kirsten Karberg¹⁵, Lars Koehler¹⁶, Torsten Matthias¹⁷, Regina Max¹⁸, Adelheid Melzer¹⁹, Dirk Meyer-Olson²⁰, Juergen Rech²¹, Karin Rockwitz²², Martin Rudwaleit²³, Eva Schweikhard¹⁷, Joachim Sieper²⁴, Carsten Stille¹⁶, Ulrich von Hinüber²⁵, Peter Wagener²⁶, Heike Weidemann²⁷ and Silke Zinke¹⁵, ¹Clinic for Immunology and Rheumatology, Hannover Medical School, Hannover, Germany, ²Medical University Hannover, Hannover, Germany, ³Clinical Immunology and Rheumatology, MD, Hannover, Germany, ⁴Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany, ⁵Rheumatology, Hannover, Hannover, Germany, ⁶Rheumatologie im Struenseehaus, Hamburg, Germany, ⁷Department of Internal Medicine, Clinic for Rheumatology and Clinical Immunology, Freiburg, Germany, ⁸Rheumapraxis Blaubeuren, Blaubeuren, Germany, ⁹Praxis Brandt-Juergens/Karberg, Berlin, Germany, ¹⁰Rheumazentrum Ruhrgebiet, Herne, Germany, ¹¹Department of Rheumatology/Clinical Immunology, Asklepios Medical Center, 93077 Bad Abbach, Germany, ¹²Rheumapraxis Hamburg, Hamburg, Germany, ¹³Department of Internal Medicine I, University of Regensburg, 93042 Regensburg, Germany, ¹⁴Rheumapraxis Nienburg, Nienburg, Germany, ¹⁵Rheumapraxis, Berlin, Germany, ¹⁶Rheumapraxis, Hannover, Germany, ¹⁷Aesku.Diagnostics, Wendelsheim, Germany, ¹⁸Dept. of Internal Medicine 5, Division of Rheumatology, University of Heidelberg, Heidelberg, Germany, ¹⁹Rheumapraxis, Seesen, Germany, ²⁰m&i Fachklinik Bad Pyrmont, Bad Pyrmont, Germany, ²¹Department of Internal Medicine 3 – Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany, ²²Rheumatologic Practice, Goslar, Germany, ²³Klinikum Bielefeld Rosenhöhe, Bielefeld, Germany, ²⁴Rheumatology Department, Charité – University Medicine Berlin, Berlin, Germany, ²⁵Rheumapraxis Hildesheim, Hildesheim, Germany, ²⁶Rheumapraxis, Nienburg, Germany, ²⁷Rheumapraxis Hannover, Hannover, Germany

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: autoantibodies and spondylarthritis, Diagnostic Tests

Session Information

Date: Monday, November 14, 2016

Title: Spondylarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment III: Axial Spondyloarthritis – Clinical

Session Type: ACR Concurrent Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose: Making the diagnosis of axial spondyloarthritis (axSpA) may be difficult. Antibodies against CD74 have been shown to be present in 2/3 of patients with long established axial SpA. InterSpA is an international multicenter study, conducted to compare the sensitivity and specificity of anti-CD74 and HLA-B27 in patients with axSpA of recent onset.

Methods: Patients between 18 and 45 years suffering from inflammatory back pain (IBP) for maximally 2 years were recruited. The presence of ankylosing spondylitis, additional inflammatory rheumatic disorders and biologic therapy were exclusion criteria. MRI of the sacroiliac joint was performed in all patients; HLA-B27 was detected by genotyping and anti-CD74 using a CE certified kit of Aesku Diagnostics (Wendelsheim, Germany). The sensitivity of anti-CD74 and HLA-B27 were calculated in patients fulfilling the imaging arm of ASAS criteria, in all patients fulfilling ASAS criteria and in 100 blood donors. Both the MRI reading as well as the laboratory procedures were performed blinded.

Results: 205 patients suffering from IBP were recruited. There were 40 recruiting failures, and complete data sets are currently available of 122 patients (mean age 29 years, mean duration of IBP 13 months, 56% male). Sacroiliitis was diagnosed by the expert reader in 67 % and HLA-B27 was positive in 69 % of the patients. 23 patients fulfilled the ASAS criteria of axSpA by the imaging arm only, 59 by both the imaging and clinical arm and 22 by the clinical arm only. The sensitivities of IgA anti-CD74, IgG anti-CD74 and HLA-B27 were 64.6%, 24.4% and 75% in the axSpA patients fulfilling the imaging arm, 65.4%, 23.1% and 80.7% in the patients fulfilling ASAS criteria, and 3%, 5% and 8% in the blood donors. The likelihood ratios are 21.5 (IgA anti-CD74), 4.9 (IgG anti-CD74) and 9.4 (HLA-B27) when considering the patients fulfilling the imaging arm, and 21.8 (IgA anti-CD74), 4.6 (IgG anti-CD74) and 10.1 (HLA-B27) when considering all patients fulfilling ASAS criteria.

Conclusion: In view of the high likelihood ratio, IgA anti-CD74 is a useful addition to our diagnostic tools for axSpA.

Disclosure: T. Witte, None; E. Riechers, None; N. T. Baerlecken, None; X. Baraliakos, AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, and Werfen, 2,AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, and Werfen, 5,AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, and Werfen, 8; K. Achilles-Mehr Bakhsh, None; P. Aries, None; B. Bannert, None; K. Becker, None; J. Brandt-Juergens, None; J. Braun, Abbott, Bristol Myers Squibb, Celgene, Celltrion, Chugai, Johnson & Johnson, MSD, Novartis, Pfizer, Roche, UCB Pharma, 2,Abbott, Bristol Myers Squibb, Celgene, Celltrion, Chugai, Johnson & Johnson, MSD, Novartis, Pfizer, Roche, UCB Pharma, 5; B. P. Ehrenstein, None; H. Euler, None; M. Fleck, None; R. Hein, None; K. Karberg, None; L. Koehler, None; T. Matthias, None; R. Max, None; A. Melzer, None; D. Meyer-Olson, None; J. Rech, None; K. Rockwitz, None; M. Rudwaleit, None; E. Schweikhard, None; J. Sieper, Abbott, Eli Lilly, Janssen, Merck, Novartis, Pfizer, UCB Pharma, 8,Abbott, Eli Lilly, Janssen, Merck, Novartis, Pfizer, UCB Pharma, 5; C. Stille, None; U. von Hinüber, None; P. Wagener, None; H. Weidemann, None; S. Zinke, None.

To cite this abstract in AMA style:

Witte T, Riechers E, Baerlecken NT, Baraliakos X, Achilles-Mehr Bakhsh K, Aries P, Bannert B, Becker K, Brandt-Juergens J, Braun J, Ehrenstein BP, Euler H, Fleck M, Hein R, Karberg K, Koehler L, Matthias T, Max R, Melzer A, Meyer-Olson D, Rech J, Rockwitz K, Rudwaleit M, Schweikhard E, Sieper J, Stille C, von Hinüber U, Wagener P, Weidemann H, Zinke S. Sensitivity and Specificity of Autoantibodies Against CD74 in Early Axial Spondyloarthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/sensitivity-and-specificity-of-autoantibodies-against-cd74-in-early-axial-spondyloarthritis/. Accessed .

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