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Abstract Number: 740

The Prevalence of Anti-DFS70 Antibodies in an International Inception Cohort of Systemic Lupus Erythematosus

May Choi1, John G. Hanly2, Murray Urowitz3,4, Juanita Romero-Diaz5, Caroline Gordon6, Sang-Cheol Bae7, Sasha Bernatsky8, Daniel J Wallace9, Joan T. Merrill10, David A. Isenberg11, Anisur Rahman12, Ellen M. Ginzler13, Paul R. Fortin14, Dafna Gladman15, Jorge Sanchez-Guerrero16, Michelle Petri17, Ian N. Bruce18, Mary Anne Dooley19, Rosalind Ramsey-Goldman20, Cynthia Aranow21, Graciela S. Alarcon22, Kristján Steinsson23, Ola Nived24, Gunnar K. Sturfelt25, Susan Manzi26, Munther Khamashta27, Ronald F. van Vollenhoven28, Asad Zoma29, Guillermo Ruiz-Irastorza30, S. Sam Lim31, Thomas Stoll32, Murat Inanc33, Kenneth C. Kalunian34, Diane L. Kamen35, Peter Maddison36, Christine A. Peschken37, Søren Jacobsen38, Anca Askanase39, Jill P. Buyon40, W. Winn Chatham41, Manuel Ramos-Casals42, Yvan St. Pierre43, Ann E. Clarke44 and Marvin J. Fritzler1, 1Medicine, University of Calgary, Calgary, AB, Canada, 2Rheumatology, Division of Rheumatology, Capital Health and Dalhousie University, Halifax, NS, Canada, 3Rheumatology, TWH, Toronto, ON, Canada, 4Rheumatology, U of Toronto, Toronto Western Hospital, Toronto, ON, Canada, 5Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico city, Mexico, 6Rheumatology (East Wing), Medical School, Birmingham, United Kingdom, 7Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea, 8Rheum/Clin. Epid., McGill MUHC/RVH, Montreal, QC, Canada, 9Cedars-Sinai Medical Center, West Hollywood, CA, 10Clinical Pharmacology, Oklahoma Medical Research Foundation, Oklahoma City, OK, 11Rayne Institute, Centre for Rheumatology Research, UCL Division of Medicine, London, United Kingdom, 12Centre for Rheumatology Research, U College of London, London, United Kingdom, 13Medicine/Box 42, SUNY-Downstate, Brooklyn, NY, 14Rheumatology, University of Laval, Quebec, QC, Canada, 15Rheumatology, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada, 16Rheumatology, Toronto Western Hospital, Toronto, ON, Canada, 17Rheumatology, Johns Hopkins University Hospital, Baltimore, MD, 18Central Manchester University Hospital NHS Foundation Trust and Manchester Academic Health Science Centre, NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester, United Kingdom, 19UNC Kidney Centre, Chapel Hill, NC, 20Northwestern University Feinberg School of Medicine, Chicago, IL, 21Feinstein Institute for Medical Research, Mahasset, NY, 22Medicine, University of Alabama at Birmingham, Birmingham, AL, 23Rheumatology, Univ. Hospital, Reykjavik, Iceland, 24Rheumatology, Inst of Clinical sciences, Lund, Sweden, 25Department of Rheumatology, Univ Hospital Lund, Lund, Sweden, 26Rheumatology, Allegheny Health Network, Pittsburgh, PA, 27Graham Hughes Lupus Research Laboratory, The Rayne Institute, St Thomas' Hospital, London, United Kingdom, 28Department of Medicine, Rheumatology Unit, Karolinska Institutet, Stockholm, Sweden, 29Rheumatology, Hairmyres Hospital, East Kilbride, United Kingdom, 30Universidad del Pais Vasco, Servicio de Medicina Interna, Hospital de Cruces, Bizkaia, Spain, 31Emory University School of Medicine, Atlanta, GA, 32Abteilung Rheumatologie/Rehab, Kantonsspital Schaffhausen, Schaffhausen, Switzerland, 33Department of Internal Medicine, Division of Rheumatology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey, 34Division of Rheumatology, Allergy & Immunology, UCSD School of Medicine Center for Innovative Therapy, La Jolla, CA, 35Medicine, Medical University of South Carolina, Charleston, SC, 36School of Sport, Health and Exercise Sciences, Bangor University, George Building, Bangor, Gwynedd, LL57 2PZ, UK., Bangor, United Kingdom, 37Rheumatology, Univ of Manitoba, Winnipeg, MB, Canada, 38Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark, 39Columbia University College of Physicians & Surgeons, New York, NY, 40Medicine, Division of Rheumatology, New York University School of Medicine, New York, NY, 41Medicine/Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, 42Department of Autoimmune Diseases, CELLEX-IDIBAPS, Hospital Clínic, Barcelona, Barcelona, Spain, 43Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montreal, QC, Canada, 44Immunology/Epidemiology, Montreal General Hospital, Montreal, QC, Canada

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: ANA, autoantibodies, biomarkers and diagnosis, SLE

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Session Information

Date: Sunday, November 8, 2015

Session Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment Poster Session I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Autoantibodies to the nuclear autoantigen dense fine speckles 70 (DFS70) are associated with a new paradigm whereby when they are found in isolation (monospecific – no other detectable autoantibodies), they are purported to rule out the diagnosis of systemic lupus erythematosus (SLE) and other anti-nuclear antibody (ANA)-related conditions. Anti-DFS70 can be screened by indirect immunofluorescence (IIF) and quantified and confirmed by chemiluminescence immunoassay (CIA). The reported frequency of anti-DFS70 by CIA in SLE is low compared to healthy individuals (0-6% vs. 7-20%). Furthermore, anti-DFS70 monospecificity is reported to be low in SLE patients (<1%). To date, there have been no studies examining the frequency of anti-DFS70 in early inception SLE cohorts. The purpose of this study was to determine the prevalence of anti-DFS70 in newly diagnosed SLE patients and to identify any univariate associations with demographic and clinical features.

Methods: Patients fulfilling the American College of Rheumatology (ACR) Classification Criteria for SLE were enrolled in the Systemic Lupus Erythematosus International Collaborating Clinics (SLICC) inception cohort within 15 months of diagnosis. Demographic and clinical data, including disease activity (SLEDAI-2K), were collected at enrollment. ANAs were detected by IIF on HEp-2 cells (ImmunoConcepts, Sacramento, CA), and extractable nuclear antigens (ENAs) and double-stranded DNA (ds-DNA) by an addressable laser bead immunoassay (FIDIS Connective 13, TheraDiag, Paris). Anti-DFS70 antibodies were measured by CIA using cutoffs suggested by the manufacturer (Inova Diagnostics Inc., San Diego, CA).

Results: 1137 patients were included; 89.4% were female and 94.4% were ANA IIF positive (Table 1). The frequency of anti-DFS70 by CIA was 7.1% [95%CI: 5.7-8.8%] (81/1137 patients). 11/1137 (0.97%) [95%CI: 0.5-1.7%] of the entire cohort were positive for anti-DFS70 only with no detectable ENA or anti-dsDNA and were therefore considered ÔmonospecificÕ for anti-DFS70. Patients with a negative anti-DFS70 by CIA were more likely than those with a positive anti-DFS70 to have other SLE-related autoantibodies including anti-U1-RNP (31.5% vs. 21.0%), anti-Ro60 (46.3% vs. 34.6%), and anti-SSB (16.0% vs. 4.9%). Age, gender, ethnicity, disease features included in the ACR classification criteria, SLEDAI-2K score, or concomitant therapies did not differ between the anti-DFS70 negative and positive patients.

Conclusion: The prevalence of anti-DFS70 measured by CIA in newly diagnosed SLE patients was at the high end of the range as compared to that in previously published SLE cohorts (7.1% vs. 0-6%). However, “monospecific” anti-DFS70 was rare (0.97%) in this SLE inception cohort and, therefore, the presence of monospecific anti-DFS70 is a potentially useful test to discriminate between ANA positive healthy individuals and those newly diagnosed with definite SLE.


Disclosure: M. Choi, None; J. G. Hanly, None; M. Urowitz, None; J. Romero-Diaz, None; C. Gordon, None; S. C. Bae, None; S. Bernatsky, None; D. J. Wallace, None; J. T. Merrill, None; D. A. Isenberg, None; A. Rahman, None; E. M. Ginzler, None; P. R. Fortin, None; D. Gladman, None; J. Sanchez-Guerrero, None; M. Petri, None; I. N. Bruce, None; M. A. Dooley, None; R. Ramsey-Goldman, None; C. Aranow, None; G. S. Alarcon, None; K. Steinsson, None; O. Nived, None; G. K. Sturfelt, None; S. Manzi, None; M. Khamashta, None; R. F. van Vollenhoven, None; A. Zoma, None; G. Ruiz-Irastorza, None; S. S. Lim, None; T. Stoll, None; M. Inanc, None; K. C. Kalunian, None; D. L. Kamen, None; P. Maddison, None; C. A. Peschken, None; S. Jacobsen, None; A. Askanase, None; J. P. Buyon, None; W. W. Chatham, None; M. Ramos-Casals, None; Y. St. Pierre, None; A. E. Clarke, None; M. J. Fritzler, Inova Diagnostics, Inc., 5,Immuno Concepts, 5.

To cite this abstract in AMA style:

Choi M, Hanly JG, Urowitz M, Romero-Diaz J, Gordon C, Bae SC, Bernatsky S, Wallace DJ, Merrill JT, Isenberg DA, Rahman A, Ginzler EM, Fortin PR, Gladman D, Sanchez-Guerrero J, Petri M, Bruce IN, Dooley MA, Ramsey-Goldman R, Aranow C, Alarcon GS, Steinsson K, Nived O, Sturfelt GK, Manzi S, Khamashta M, van Vollenhoven RF, Zoma A, Ruiz-Irastorza G, Lim SS, Stoll T, Inanc M, Kalunian KC, Kamen DL, Maddison P, Peschken CA, Jacobsen S, Askanase A, Buyon JP, Chatham WW, Ramos-Casals M, St. Pierre Y, Clarke AE, Fritzler MJ. The Prevalence of Anti-DFS70 Antibodies in an International Inception Cohort of Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/the-prevalence-of-anti-dfs70-antibodies-in-an-international-inception-cohort-of-systemic-lupus-erythematosus/. Accessed March 27, 2023.
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