An international multicenter retrospective analysis of repeated anti-ENA testing in ANA-associated rheumatic diseases, a data-driven proposal to increase testing efficacy
Background: Autoantibodies detection in ANA-associated rheumatic diseases (AARD) is not only used for diagnostic and classification purposes, but also for monitoring. In case of AARD it is questioned if repeated anti-ENA testing is of any substantial value. In this international multicenter retrospe...
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Elsevier
2025-12-01
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| Series: | Journal of Translational Autoimmunity |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589909025000334 |
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| author | Wim H.M. Vroemen Maria Infantino Mariangela Manfredi Joyce J.B.C. van Beers Carolien Bonroy Jan G.M.C. Damoiseaux |
| author_facet | Wim H.M. Vroemen Maria Infantino Mariangela Manfredi Joyce J.B.C. van Beers Carolien Bonroy Jan G.M.C. Damoiseaux |
| author_sort | Wim H.M. Vroemen |
| collection | DOAJ |
| description | Background: Autoantibodies detection in ANA-associated rheumatic diseases (AARD) is not only used for diagnostic and classification purposes, but also for monitoring. In case of AARD it is questioned if repeated anti-ENA testing is of any substantial value. In this international multicenter retrospective study, repeated anti-ENA testing according to local AARD testing algorithms was investigated. Methods: Anti-ENA results (anti-SSA60, -Ro52, -SSB, -Scl-70, -CENP-B, -RNP, -Sm) over a 6 to 10-year period were extracted from the laboratory information systems of three participating centers. Time between repeated testing was determined and concordance analysis was performed. Results: The study included 28557 anti-ENA requests from 19388 patients (72 % female). In 15227 patients (78.5 %) only one anti-ENA test was performed (79.9 % negative), while 4161 patients (21.5 %) underwent multiple (median [interquartile range (IQR)]; 2 [2–4]) tests with a maximum of 31 tests. The median [IQR] time interval between anti-ENA testing for the total cohort was 364 [195–539] days. Concordance analysis demonstrated that repeated anti-ENA test results did not show any change in 3583 patients (86.1 %). Additional autoantibodies were observed in 243 patients (5.8 %). In 76 (1.8 %) patients a positive anti-ENA test was obtained after an initial negative anti-ENA test result, while in 167 (4.0 %) patients additional autoantibodies were detected after an initial positive anti-ENA result. Conclusions: Repeated anti-ENA testing with a median time interval of about one year is common independently of local laboratory testing algorithms, but showed a limited added value since only 1.8 % of the patients have demonstrated a positive anti-ENA test after an initial negative anti-ENA test. These data at least suggest that repeated anti-ENA tests should be discouraged and only be instigated by a change in clinical manifestations. |
| format | Article |
| id | doaj-art-ca7337777b02443cb2e67ea5f98972aa |
| institution | DOAJ |
| issn | 2589-9090 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
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| series | Journal of Translational Autoimmunity |
| spelling | doaj-art-ca7337777b02443cb2e67ea5f98972aa2025-08-20T03:24:04ZengElsevierJournal of Translational Autoimmunity2589-90902025-12-011110029810.1016/j.jtauto.2025.100298An international multicenter retrospective analysis of repeated anti-ENA testing in ANA-associated rheumatic diseases, a data-driven proposal to increase testing efficacyWim H.M. Vroemen0Maria Infantino1Mariangela Manfredi2Joyce J.B.C. van Beers3Carolien Bonroy4Jan G.M.C. Damoiseaux5Central Diagnostic Laboratory, Maastricht University Medical Center+, Maastricht, The NetherlandsImmunology and Allergology Laboratory, S. Giovanni di Dio Hospital, Florence, ItalyImmunology and Allergology Laboratory, S. Giovanni di Dio Hospital, Florence, ItalyCentral Diagnostic Laboratory, Maastricht University Medical Center+, Maastricht, The NetherlandsDepartment of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium; Department of Diagnostic Science, Ghent University, Ghent, BelgiumCentral Diagnostic Laboratory, Maastricht University Medical Center+, Maastricht, The Netherlands; Corresponding author. Central Diagnostic Laboratory, Maastricht University Medical Center+, P. Debyelaan 25. 6229 HX, Maastricht, The Netherlands.Background: Autoantibodies detection in ANA-associated rheumatic diseases (AARD) is not only used for diagnostic and classification purposes, but also for monitoring. In case of AARD it is questioned if repeated anti-ENA testing is of any substantial value. In this international multicenter retrospective study, repeated anti-ENA testing according to local AARD testing algorithms was investigated. Methods: Anti-ENA results (anti-SSA60, -Ro52, -SSB, -Scl-70, -CENP-B, -RNP, -Sm) over a 6 to 10-year period were extracted from the laboratory information systems of three participating centers. Time between repeated testing was determined and concordance analysis was performed. Results: The study included 28557 anti-ENA requests from 19388 patients (72 % female). In 15227 patients (78.5 %) only one anti-ENA test was performed (79.9 % negative), while 4161 patients (21.5 %) underwent multiple (median [interquartile range (IQR)]; 2 [2–4]) tests with a maximum of 31 tests. The median [IQR] time interval between anti-ENA testing for the total cohort was 364 [195–539] days. Concordance analysis demonstrated that repeated anti-ENA test results did not show any change in 3583 patients (86.1 %). Additional autoantibodies were observed in 243 patients (5.8 %). In 76 (1.8 %) patients a positive anti-ENA test was obtained after an initial negative anti-ENA test result, while in 167 (4.0 %) patients additional autoantibodies were detected after an initial positive anti-ENA result. Conclusions: Repeated anti-ENA testing with a median time interval of about one year is common independently of local laboratory testing algorithms, but showed a limited added value since only 1.8 % of the patients have demonstrated a positive anti-ENA test after an initial negative anti-ENA test. These data at least suggest that repeated anti-ENA tests should be discouraged and only be instigated by a change in clinical manifestations.http://www.sciencedirect.com/science/article/pii/S2589909025000334ANA-Associated rheumatic diseasesExtractable nuclear antigen antibodiesLaboratory algorithms |
| spellingShingle | Wim H.M. Vroemen Maria Infantino Mariangela Manfredi Joyce J.B.C. van Beers Carolien Bonroy Jan G.M.C. Damoiseaux An international multicenter retrospective analysis of repeated anti-ENA testing in ANA-associated rheumatic diseases, a data-driven proposal to increase testing efficacy Journal of Translational Autoimmunity ANA-Associated rheumatic diseases Extractable nuclear antigen antibodies Laboratory algorithms |
| title | An international multicenter retrospective analysis of repeated anti-ENA testing in ANA-associated rheumatic diseases, a data-driven proposal to increase testing efficacy |
| title_full | An international multicenter retrospective analysis of repeated anti-ENA testing in ANA-associated rheumatic diseases, a data-driven proposal to increase testing efficacy |
| title_fullStr | An international multicenter retrospective analysis of repeated anti-ENA testing in ANA-associated rheumatic diseases, a data-driven proposal to increase testing efficacy |
| title_full_unstemmed | An international multicenter retrospective analysis of repeated anti-ENA testing in ANA-associated rheumatic diseases, a data-driven proposal to increase testing efficacy |
| title_short | An international multicenter retrospective analysis of repeated anti-ENA testing in ANA-associated rheumatic diseases, a data-driven proposal to increase testing efficacy |
| title_sort | international multicenter retrospective analysis of repeated anti ena testing in ana associated rheumatic diseases a data driven proposal to increase testing efficacy |
| topic | ANA-Associated rheumatic diseases Extractable nuclear antigen antibodies Laboratory algorithms |
| url | http://www.sciencedirect.com/science/article/pii/S2589909025000334 |
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