Rheumatologists could save money by not ordering repeat tests that, with some exceptions, don’t change over time, says Dr. Pope. The cost to the patient runs about half the price of a follow-up visit, and the results provide minimal new information, she says.
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“So it’s not worth it,” says Dr. Pope, noting that tests for anti-ENA should be ordered once in an SLE patient “unless a new disease has evolved, such as another connective tissue disease.”
“However, if a patient is contemplating pregnancy or is early in pregnancy and her previous status was Ro negative, then you may want to check to see if it became positive,” says Dr. Pope.
The study found anti-ENA results seldom change one year to the next especially after one or more test is negative. Anti-dsDNA and complements change more frequently after an abnormal result, but less after a normal value, the authors concluded.
“While we did not investigate the clinical implications of changes, published data show little predictive value of anti-ENA,” states the article. “Routine annual anti-ENA testing is likely not necessary in SLE-patients with consistent results, especially if they are negative.”
Study limitations noted by the authors include that data were collected from a single site and researchers did not assess whether changes in test results correlate with any clinical or treatment event. In addition, most tests were performed at one laboratory, which may limit applicability to patients whose tests are performed at multiple laboratories.
Catherine Kolonko is a medical writer based in Oregon.
- Raissi TC, Hewson C, Pope JE. Repeat testing of antibodies and complements in systemic lupus erythematosus: When is it enough? J Rheumatol. 2018 Jun;45(6):827–834.