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Meta-Analysis
. 2021 May;24(5):633-646.
doi: 10.1111/1756-185X.14093. Epub 2021 Mar 13.

Diagnostic value of anti-citrullinated α-enolase peptide 1 antibody in patients with rheumatoid arthritis: A systematic review and meta-analysis

Haolong Li  1 , Liubing Li  1 , Chenxi Liu  1 , Linlin Cheng  1 , Songxin Yan  1 , Haizhen Chen  1   2 , Yongzhe Li  1
Affiliations
Meta-Analysis

Diagnostic value of anti-citrullinated α-enolase peptide 1 antibody in patients with rheumatoid arthritis: A systematic review and meta-analysis

Haolong Li et al. Int J Rheum Dis. 2021 May.

Abstract

Aim: To evaluate the diagnostic value of anti-citrullinated α-enolase peptide 1 (anti-CEP 1) antibody in patients with rheumatoid arthritis (RA) by conducting a systematic review and meta-analysis.

Methods: The PubMed, Web of Science, Embase, Scopus, and Cochrane Library databases were searched for relevant studies published until September 23, 2020. A bivariate mixed-effects model was used to calculate the diagnostic indices from primary data of eligible studies. We performed meta-regression and subgroup analysis to explore the sources of heterogeneity.

Results: Twenty-four articles, with a total of 17 380 patients with RA and 7505 control participants, met the criteria for inclusion in the meta-analysis. The pooled sensitivity, specificity, and positive and negative likelihood ratios for the anti-CEP 1 antibody were 44% (95% CI: 38%-51%), 97% (95% CI: 96%-98%), and 14.81 (95% CI: 10.66-20.57) and 0.57 (95% CI: 0.52-0.64), respectively. The pooled positive and negative predictive values were 0.96 (95% CI: 0.95-0.97) and 0.53 (95% CI: 0.43-0.63), respectively. The area under the summary receiver operating characteristic curve was 0.86. Meta-regression indicated that the anti-CEP 1 antibody detection method may be a source of heterogeneity. The subgroup analysis of the group in which the anti-CEP 1 antibody was detected by using a commercial enzyme-linked immunosorbent assay (ELISA) kit had a sensitivity of 59% (95% CI: 50%-68%) and a specificity of 93% (95% CI: 85%-97%).

Conclusions: The anti-CEP 1 antibody had moderate RA diagnostic value with relatively low sensitivity and high specificity. An ELISA may increase the RA diagnostic sensitivity.

Keywords: anti-citrullinated protein antibodies; anti-citrullinated α-enolase peptide 1 antibody; autoantibody; diagnosis; meta-analysis; rheumatoid arthritis.

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Conflict of interest statement

The authors declare they have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram for screening studies and results
FIGURE 2
FIGURE 2
Literature quality assessment by using the Quality Assessment of Diagnostic Accuracy Studies‐2 (QUADAS‐2) tool for eligible studies
FIGURE 3
FIGURE 3
Forest plots and summary receiver operating characteristic curves of the anti‐citrullinated α‐enolase peptide 1 (anti‐CEP 1) for rheumatoid arthritis (RA). (A) Sensitivity forest plot; (B) specificity forest plot; (C) summary receiver operating characteristic curve
FIGURE 4
FIGURE 4
Univariable meta‐regression and subgroup analysis of 3 covariates (control group, diagnostic criteria for rheumatoid arthritis (RA), method for detection of the anti‐citrullinated α‐enolase peptide 1 [anti‐CEP 1] antibody)
See this image and copyright information in PMC

References

    1. Smolen JS, Aletaha D, Barton A, et al. Rheumatoid arthritis. Nat Rev Dis Primers. 2018;4:18001. 10.1038/nrdp.2018.1 - DOI - PubMed
    1. Lee YH, Song GG. Impact of Janus kinase inhibitors on the risk of cardiovascular events in patients with rheumatoid arthritis: systematic review and meta‐analysis of randomised controlled trials. Ann Rheum Dis. 2020;79(10):e122. 10.1136/annrheumdis-2019-215815 - DOI - PubMed
    1. Johnson C. Recent advances in the pathogenesis, prediction, and management of rheumatoid arthritis‐associated interstitial lung disease. Curr Opin Rheumatol. 2017;29(3):254‐259. 10.1097/bor.0000000000000380 - DOI - PubMed
    1. Aletaha D, Smolen JS. Diagnosis and management of rheumatoid arthritis: a review. JAMA. 2018;320(13):1360‐1372. 10.1001/jama.2018.13103 - DOI - PubMed
    1. Bugatti S, Manzo A, Montecucco C, Caporali R. The clinical value of autoantibodies in rheumatoid arthritis. Front Med. 2018;5:339. 10.3389/fmed.2018.00339 - DOI - PMC - PubMed

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