Analytical and clinical performance of the updated Elecsys Anti-TPO II assay for the detection of antibodies against thyroid peroxidase to aid in the diagnosis of autoimmune thyroid diseases.

Document Type

Article

Publication Date

6-8-2026

Publication Title

Clinical chemistry and laboratory medicine : CCLM / FESCC

Abstract

OBJECTIVES: Use of polyclonal antibodies (pAbs) in immunoassays has limitations related to inter-batch variation and supply chain stability which may affect assay reproducibility, scalability, and sustainability. The Elecsys

METHODS: Repeatability, intermediate precision, and reproducibility were assessed over 5 days at three sites, within/between multiple reagent lots and analyzers. Method comparisons were performed against Elecsys Anti-TPO and three other immunoassays, using 218 serum samples covering the measuring range. The clinical cutoff was derived from 85 patients with confirmed Hashimoto thyroiditis (HT); reference intervals determined using samples from 230 healthy euthyroid individuals. Clinical performance was evaluated in 608 patients with confirmed HT, Graves disease, non-autoimmune thyroid diseases, or non-thyroid autoimmune diseases.

RESULTS: Elecsys Anti-TPO II demonstrated high precision (standard deviations for repeatability, intermediate precision, and reproducibility < 1.6 IU/mL for measurements ≤30 IU/mL; coefficients of variation < 7 % for measurements >30 IU/mL) and improved semi-quantitative agreement (94.0-97.7 %) with comparator assays, vs. Elecsys Anti-TPO (88.5-90.8 %). The 95th percentile of the reference range cohort was < 8 IU/mL; specificity in this cohort was 97.4 % (cutoff of ≥20 IU/mL). Clinical sensitivity for HT was 90.5 %; clinical specificity in disease control groups was 90.7 %.

CONCLUSIONS: Elecsys Anti-TPO II offers robust analytical and clinical performance, supporting its utility in diagnosing auto-immune thyroid diseases in routine clinical practice.

DOI

10.1515/cclm-2026-0044

ISSN

1437-4331

PubMed ID

42259764

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