Diagnostic value of anti-citrullinated fibrinogen antibody in rheumatoid arthritis: A meta-analysis

Int J Rheum Dis. 2019 Apr;22(4):599-607. doi: 10.1111/1756-185X.13477. Epub 2019 Feb 6.

Abstract

Aim: To evaluate the overall diagnostic value of anti-citrullinated fibrinogen (ACF) antibody in patients with rheumatoid arthritis (RA).

Methods: Published studies were systematically retrieved from PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wan Fang, China Biology Medicine (CBM) disc, and Chinese VIP databases. QUADAS-2 tool was applied to evaluate the quality of eligible studies. Subgroup analysis and meta-regression were used to explore the sources of heterogeneity. Egger's test was used to evaluate for the presence of publication bias.

Results: Seven studies were included in this meta-analysis. The pooled sensitivity, specificity, pooled positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of ACF were 0.61 (95% CI: 0.57-0.64), 0.93 (95% CI: 0.92-0.94), 9.33 (95% CI: 5.15-16.92), 0.39 (95% CI: 0.30-0.53) and 24.58 (95% CI: 11.47-52.64), respectively. The area under the curve was 0.8018. The results of subgroup analysis and meta-regression indicated that the factors we analyzed might not be the leading causes of heterogeneity. No significant publication bias was found.

Conclusion: The ACF antibody had a moderate diagnostic accuracy on RA.

Keywords: anti-citrullinated fibrinogen antibody; diagnosis; meta-analysis; rheumatoid arthritis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Anti-Citrullinated Protein Antibodies / blood*
  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / diagnosis*
  • Arthritis, Rheumatoid / immunology
  • Biomarkers / blood
  • Fibrinogen / immunology*
  • Humans
  • Peptides, Cyclic / immunology*
  • Predictive Value of Tests
  • Prognosis
  • Reproducibility of Results

Substances

  • Anti-Citrullinated Protein Antibodies
  • Biomarkers
  • Peptides, Cyclic
  • cyclic citrullinated peptide
  • Fibrinogen