The Association Between the PTPN22 C1858T Variant and Vasculitis: A Meta-analysis Update with Trial Sequential Analysis.

Objective: The present study was designed to determine whether the protein tyrosine phosphatase non-receptor 22 (PTPN22) C1858T variant is associated with susceptibility to vasculitis. Methods: A meta-analysis was conducted to evaluate the association between the PTPN22 C1858T variant and vasculitis. A trial sequential analysis was performed to evaluate the robustness of the meta-analysis. Results: A total of 17 studies were included in this meta-analysis which revealed a highly significant association between the PTPN22 T allele and vasculitis of multiple types (odds ratio [OR] = 4.850, 95% confidence interval [CI] = 3.043-7.729, p < 0.001). Meta-analysis by vasculitis type showed an association between the T allele and risk of giant cell arteritis (GCA) and antineutrophil cytoplasmic antibody-associated vasculitis (AAV) (OR = 7.505, 95% CI = 3.605-15.62, p < 0.001; OR = 6.121, 95% CI = 3.216-11.65, p < 0.001). The meta-analysis also indicated an association between the T allele and Takayasu's arteritis, but not between the T allele and Behcet's disease or Henoch-Schönlein purpura. TSA indicated that the observed association is conclusive with the existing evidence. Conclusions: This meta-analysis confirms that the PTPN22 C1858T variant is associated with susceptibility to GCA and AAV.