Antibodies to citrullinated proteins/peptides (ACPAs) are the second serological marker to have recently been included in the 2010 ACR/EULAR Rheumatoid Arthritis (RA) Classification Criteria, which are focused on early diagnosis and therapy. This review discusses their history and some clinical aspects of ACPAs, focusing on the diagnostic utility of anti-cyclic citrullinated peptide (anti-CCP) antibodies as a marker of RA as compared to the widely used rheumatoid factor (RF). Simultaneously, this review aims to raise physician awareness and interest in anti-citrullinated vimentin antibody (anti-Sa/anti-MCV), another member of the ACPA family, which appears to have a better predictive value as a marker of RA than anti-CCP or RF and correlates closely with disease activity and therapeutic response among patients with RA.

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Aim: To evaluate the prevalence and diagnostic significance of the autoantibody against citrullinated vimentin (anti-Sa) compared with the widely used anti-cyclic citrullinated peptide autoantibody (anti-CCP) in patients with rheumatoid arthritis (RA).Method: One hundred and sixty-nine patients hospitalized at the Department of Rheumatology and Internal Medicine, Poznan University of Medical Sciences, Pozna n, Poland, were enrolled in a cross-sectional study and divided into two groups. The RA group comprised 41 patients diagnosed as having RA. The non-RA control group included 128 individuals with a variety of rheumatic disorders. Serum anti-Sa and anti-CCP measurements were performed by enzyme-linked immunosorbent assay. Results:The sensitivity and specificity of anti-Sa for the diagnosis of RA was 36.6% and 96.9%, respectively. For the anti-CCP test, the sensitivity was 65.9% and the specificity was 95.3%. Concomitant presence of anti-Sa and anti-CCP was determined in 36.6% of the patients with RA, whereas isolated positivity of anti-Sa was not observed. Anti-Sa positive RA patients had significantly higher anti-CCP levels compared to anti-Sa negative subjects (P < 0.05). Conclusion:With regard to the relatively low diagnostic sensitivity and the lack of cases identified by anti-Sa alone, we were unable to demonstrate any additional diagnostic value of the anti-Sa autoantibody in comparison to the anti-CCP autoantibody. To the authors' best knowledge, this is the first study among Polish patients verifying the clinical utility of anti-Sa in the diagnosis of RA.

Background: Remdesivir (RDV) is the only antiviral drug registered currently for treatment of COVID-19 after a few clinical trials with controversial results. The purpose of this study was to evaluate the effectiveness and safety of RDV in patients with COVID-19 in real world settings. Methods: Patients were selected from 1496 individuals included in the SARSTer national database; 122 of them received therapy with RDV and 211 were treated with lopinavir/ritonavir (LPV/r)-based therapy. The primary end-point of effectiveness was clinical improvement in the ordinal 8-point scale, which was defined as a 2-point decrease from baseline to 7, 14, 21 and 28 days of hospitalization. The secondary end-points of effectiveness included: death rate, rate of no clinical improvement within 28 days of hospitalization in the ordinal scale, rate of the need for constant oxygen therapy, duration of oxygen therapy, rate of the need for mechanical ventilation, total hospitalization time, and rate of positive RT PCR for SARS-CoV-2 after 30 days. Findings: Significantly higher rates of clinical improvement, by 15% and 10% respectively, were observed after RDV treatment compared to LPV/r at days 21 and 28. The difference between regimens increased with worsening of oxygen saturation (SpO2) and depending on the baseline score from the ordinal scale. Statistically significant differences supporting RDV were also noted regarding the rate of no clinical improvement within 28 days of hospitalization and hospitalization duration in patients with baseline SpO2 ≤90%. In the logistic regression model only the administration of remdesivir was independently associated with at least a 2-point improvement in the ordinal scale between baseline and day 21. Interpretation: In conclusion, data collected in this retrospective, observational, real world study supported use of remdesivir for treatment of SARS-CoV-2 infection particularly in patients with oxygen saturation ≤95%.

The paper summarises the present knowledge of the new bone densitometry method called radiofrequency echographic multi-spectrometry (REMS). This ultrasound-based approach enables the evaluation of bone mineral density (BMD) in the hip and the lumbar spine. During REMS densitometry, a fully automatic algorithm performs a series of spectral and statistical analyses involving both echographic images and corresponding "raw" (unfiltered) radiofrequency signals. This provides the identification of the region of interest (ROI) and the calculation of standard densitometric parameters: BMD, T-score and Z-score. Nondiagnostic scans and artifacts are automatically excluded by the algorithm, reducing the risk of false results. A recently published multi-center study has demonstrated high diagnostic sensitivity, specificity and accuracy of this innovative method in the diagnosis of osteoporosis. To the authors' best knowledge, this is the first Polish paper on REMS densitometry.