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Meta-analysis: diagnostic accuracy of antibody against peptidylarginine deiminase 4 by ELISA for rheumatoid arthritis

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Abstract

The antibody against peptidylarginine deiminase (PAD) 4 is a biomarker that might be helpful in the diagnosis of rheumatoid arthritis (RA). We aim to estimate the diagnostic value of anti-PAD4 antibody for RA by meta-analysis. We searched PubMed, Embase, the Cochrane Library, Web of Science, and Scopus for studies published in any languages in March 1, 2017 that evaluated the diagnostic accuracy of the anti-PAD4 antibody for the diagnosis of RA. The articles that detected the anti-PAD4 antibody by enzyme-linked immunosorbent assay (ELISA) and used healthy donors or patients without arthritis or arthralgia as controls were included for meta-analysis. The articles were assessed by Quality Assessment of Diagnostic Accuracy Studies tool. A bivariate mixed-effects model was used to summarize the diagnostic indexes from eight eligible studies. The pooled sensitivity, specificity, and positive and negative likelihood ratios for anti-PAD4 antibody were 38% (95% CI 30.0–46.0%), 96% (95% CI 93.0–98.0%), 8.96 (95% CI 5.00–16.05), and 0.65 (95% CI 0.57–0.74), respectively. The summary diagnostic odds ratios were 13.74 (95% CI 7.23–26.09), and the area under the summary receiver operator characteristic curve was 86% (95% CI 83–89%). Anti-PAD4 antibody detected by ELISA shows a high value in the diagnosis of RA with high specificity, but relatively low sensitivity.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (Grant no. 81571573).

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  1. Department of Rheumatology and Immunology, Peking University Third Hospital, No. 49, North Garden Road, Beijing, 100191, China

    Jiaqi Ren, Lin Sun & Jinxia Zhao

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  1. Jiaqi Ren
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  2. Lin Sun
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Correspondence to Jinxia Zhao.

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Ren, J., Sun, L. & Zhao, J. Meta-analysis: diagnostic accuracy of antibody against peptidylarginine deiminase 4 by ELISA for rheumatoid arthritis. Clin Rheumatol 36, 2431–2438 (2017). https://doi.org/10.1007/s10067-017-3809-0

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  • DOI: https://doi.org/10.1007/s10067-017-3809-0

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