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Войти в исследования Frontiers in immunology · 2026
Network meta-analysis of novel diagnostic biomarkers for rheumatoid arthritis: comparative performance of anti-CarP, anti-MCV, and emerging markers.
СтатьяNetwork Meta-AnalysisСравнительное исследованиеСистематический обзорНазвание и аннотация: Перевод в очереди
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Li Guanghui, Tan Limin, Liu Jiayan, Wang Manxiang
Аннотация
OBJECTIVE: Rheumatoid arthritis (RA) diagnosis remains challenging due to the limitations of conventional biomarkers. This network meta-analysis (NMA) aimed to compare the diagnostic performance of seven novel biomarkers for RA.
METHODS: We systematically searched EMBASE, PubMed, and Cochrane databases, identifying 1,713 records. Twelve studies met inclusion criteria. Diagnostic accuracy metrics (sensitivity, specificity, log diagnostic odds ratio [lnDOR]) were extracted. A frequentist NMA was performed using the netmeta package in R, with biomarkers ranked via P-scores against the ACR/EULAR RA criteria. Heterogeneity, transitivity, and publication bias were assessed.
RESULTS: Anti-carbamylated protein (Anti-CarP) antibody showed the highest diagnostic efficacy (P-score = 0.80; sensitivity 62 - 64%, specificity 89%), followed by anti-mutated citrullinated vimentin (Anti-MCV; P-score = 0.69). miR- 146a and power Doppler ultrasound (PDUS) demonstrated moderate performance (P-scores 0.46 and 0.45), while 14-3-3 η protein (P-score = 0.26) and its combination with ACPA (P-score = 0.07) ranked lowest. The network exhibited a star-shaped geometry with no significant inconsistency or publication bias (Egger 's test p = 0.52).
CONCLUSION: Anti-CarP and Anti-MCV are the most promising diagnostic biomarkers for RA, Anti-CarP and Anti-MCV are the most promising diagnostic biomarkers for RA. Their potential utility in seronegative or early-stage RA warrants further investigation. The limited performance of 14-3-3 η challenges prior assumptions about its utility. Standardized thresholds and direct comparisons are needed for validation.
METHODS: We systematically searched EMBASE, PubMed, and Cochrane databases, identifying 1,713 records. Twelve studies met inclusion criteria. Diagnostic accuracy metrics (sensitivity, specificity, log diagnostic odds ratio [lnDOR]) were extracted. A frequentist NMA was performed using the netmeta package in R, with biomarkers ranked via P-scores against the ACR/EULAR RA criteria. Heterogeneity, transitivity, and publication bias were assessed.
RESULTS: Anti-carbamylated protein (Anti-CarP) antibody showed the highest diagnostic efficacy (P-score = 0.80; sensitivity 62 - 64%, specificity 89%), followed by anti-mutated citrullinated vimentin (Anti-MCV; P-score = 0.69). miR- 146a and power Doppler ultrasound (PDUS) demonstrated moderate performance (P-scores 0.46 and 0.45), while 14-3-3 η protein (P-score = 0.26) and its combination with ACPA (P-score = 0.07) ranked lowest. The network exhibited a star-shaped geometry with no significant inconsistency or publication bias (Egger 's test p = 0.52).
CONCLUSION: Anti-CarP and Anti-MCV are the most promising diagnostic biomarkers for RA, Anti-CarP and Anti-MCV are the most promising diagnostic biomarkers for RA. Their potential utility in seronegative or early-stage RA warrants further investigation. The limited performance of 14-3-3 η challenges prior assumptions about its utility. Standardized thresholds and direct comparisons are needed for validation.