Response to ‘Titre-specific positive predictive value of anti-nuclear antibody patterns’ by Vulsteke<i>et al</i>

Damoiseaux, Jan; Andrade, Luís Eduardo Coelho; Fritzler, Marvin J.; Herold, Manfred; Infantino, María; Mühlen, C von

doi:10.1136/annrheumdis-2019-216266

Cited by 1 publication

(1 citation statement)

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“…Although most experts suggest using monospecific anti-DFS70 antibodies to exclude SARD [ 2 , 13 , 14 ], we found that in patients presenting with a positive ANA test, using anti-DFS70 antibodies alone without concomitant autoantibody tests could still achieve good specificity [ 38 ]. In apparently healthy individuals, the prevalence of anti-DFS70 antibodies has been reported to be no higher than 30% [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Anti-DFS70 Antibodies for Differentiating Systemic Autoimmune Rheumatic Disease in Patients with Positive ANA Tests: A Systematic Review and Meta-Analysis

et al. 2021

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Anti-DFS70 antibodies have been proposed as a marker to exclude systemic autoimmune rheumatic disease (SARD). We conducted this systematic diagnostic test accuracy review and meta-analysis to determine the performance of anti-DFS70 antibodies in patients with a positive anti-nuclear antibody (ANA) test result to exclude SARD. We searched PubMed, Embase, Web of Science, Scopus and the Cochrane Library up to 22 February 2021, and included studies examining the diagnostic accuracy of anti-DFS70 antibodies in patients with a positive ANA test result. The results were pooled using a hierarchical bivariate model and plotted in summary receiver operating characteristic curves. R software and Stata Statistical Software were used for the statistical analysis. Eight studies with 4168 patients were included. The summary sensitivity was 0.19 (95% confidence interval: 0.12–0.28) and the specificity was 0.93 (95% confidence interval: 0.88–0.96). The area under the curve was 0.69 (95% confidence interval: 0.64–0.72). The meta-regression analysis showed that targeting only ANA-associated rheumatic disease was associated with higher specificity. In addition, the studies with a non-SARD prevalence of <80% and using a chemiluminescence assay were associated with higher specificity. Anti-DFS70 antibodies have high specificity for the exclusion of SARD among patients presenting with a positive ANA test, but the sensitivity is low.

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