Diagnostic accuracy of anti-carbamylated protein antibodies in rheumatoid arthritis: a systematic review and meta-analysis.

IF 2.9 3区 医学 Q2 RHEUMATOLOGY
Pannathorn Nakaphan, Patavee Pajareya, Priabprat Jansem, Somkiat Phutinart, Nattanicha Chaisrimaneepan, Tanattida Kassels, Noppachai Siranart
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引用次数: 0

Abstract

Anti-carbamylated protein (anti-CarP) antibodies have emerged as novel serologic markers in rheumatoid arthritis (RA). This meta-analysis aimed to assess the diagnostic accuracy of anti-CarP antibodies in RA patients.A systematic Literature search was conducted through April 2025. Primary outcome was diagnostic accuracy of anti-CarP antibodies compared to healthy controls; secondary outcomes included subgroup analyses by anti-citrullinated protein antibodies (ACPA) status.Thirty-six studies (7431 RA patients; 3347 healthy controls) were included. Most used in-house ELISA platforms. Overall, Anti-CarP antibodies showed high specificity but Limited sensitivity in detecting RA with pooled sensitivity and specificity of 44% (95% CI: 39-49%, I²=91.5%) and 96% (95%CI: 94-97%, I²=65.5%), respectively. The pooled diagnostic odds ratio was 14.72 (95%CI: 10.75-20.15, I2 = 62.1%), and the area under the summary receiver operating characteristic (SROC) curve was 0.825 (95%CI: 0.797-0.854). In subgroup analysis with studies using carbamylated fetal calf serum as targeted antigen (n = 16), sensitivity and specificity were 41% (95%CI: 38-45%, I²=82.3%) and 96% (95%CI: 95-98%, I²=59.6%). In ACPA-negative patients, sensitivity was 24% (95%CI: 18-31%, I²=87.2%), and specificity was 95% (95%CI: 93-97%, I²=70.3%) with the area under the SROC of 0.755 (95%CI: 0.705-0.805). In ACPA-positive patients, sensitivity was 49% (95% CI: 41-57%, I²=94.0%), and specificity was 95% (95%CI: 93-97%, I²=72.0%) with the area under the SROC of 0.855 (95% CI: 0.806-0.904).Anti-CarP antibodies demonstrate high specificity but limited sensitivity for RA diagnosis. PROSPERO registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251065177 .

抗氨甲酰化蛋白抗体在类风湿关节炎中的诊断准确性:一项系统回顾和荟萃分析。
抗氨基甲酰化蛋白(anti-CarP)抗体已成为类风湿关节炎(RA)的新型血清学标志物。本荟萃分析旨在评估抗鲤鱼抗体在RA患者中的诊断准确性。系统的文献检索进行到2025年4月。主要终点是与健康对照组相比,抗鲤鱼抗体的诊断准确性;次要结果包括抗瓜氨酸蛋白抗体(ACPA)状态的亚组分析。共纳入36项研究(7431例RA患者,3347例健康对照)。大多数使用内部ELISA平台。总的来说,Anti-CarP抗体检测RA具有高特异性,但敏感性有限,合并敏感性和特异性分别为44% (95%CI: 39 ~ 49%, I²=91.5%)和96% (95%CI: 94 ~ 97%, I²=65.5%)。合并诊断优势比为14.72 (95%CI: 10.75 ~ 20.15, I2 = 62.1%),总受试者工作特征(SROC)曲线下面积为0.825 (95%CI: 0.797 ~ 0.854)。在以氨甲酰化胎牛血清作为靶抗原(n = 16)的亚组分析中,灵敏度和特异性分别为41% (95%CI: 38-45%, I²=82.3%)和96% (95%CI: 95-98%, I²=59.6%)。acpa阴性患者的敏感性为24% (95% ci: 18 ~ 31%, I²=87.2%),特异性为95% (95% ci: 93 ~ 97%, I²=70.3%),SROC下面积为0.755 (95% ci: 0.705 ~ 0.805)。acpa阳性患者的敏感性为49% (95%CI: 41 ~ 57%, I²=94.0%),特异性为95% (95%CI: 93 ~ 97%, I²=72.0%),SROC下面积为0.855 (95%CI: 0.806 ~ 0.904)。抗鲤鱼抗体对RA诊断具有高特异性,但敏感性有限。普洛斯彼罗注册:https://www.crd.york.ac.uk/PROSPERO/view/CRD420251065177。
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来源期刊
Rheumatology International
Rheumatology International 医学-风湿病学
CiteScore
7.30
自引率
5.00%
发文量
191
审稿时长
16. months
期刊介绍: RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology. RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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