Usefulness of anti‐p155 autoantibody for diagnosing cancer‐associated dermatomyositis: A systematic review and meta‐analysis

Trallero-Araguás, Ernesto; Rodrigo-Pendás, José Ángel; Selva-O’Callaghan, Albert; Martínez‐Gómez, Xavier; Bosch, Xavier; Labrador‐Horrillo, Moisés; Grau-Junyent, Josep María; Vilardell‐Tarrés, Miquel

doi:10.1002/art.33379

Cited by 298 publications

(226 citation statements)

References 53 publications

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“…Ryzyko to zostało dokładniej ocenione przez Trallero-Araguasa i wsp. [38] w metaanalizie dotyczącej 6 badań kohortowych, uwzględniającej łącznie dane 312 chorych z DM. Opisywane przeciwciała cechuje 89-procentowa swoistość i 78-procentowa czułość dla stwierdzenia nowotworu, z dodatnią wartością predykcyjną wynoszącą 58%, a ujemną wartością predykcyjną -aż 95%.…”

Section: Przeciwciała Anty-mda5 (Anty-cadm-140)unclassified

Special papers Diagnostic and therapeutic advances in dermatomyositis

Samotij¹,

Szczęch²,

Reich³

2015

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StreSzczenieZapalenie skórno-mięśniowe (dermatomyositis -DM) zalicza się do grupy tzw. idiopatycznych miopatii zapalnych (ang. idiopathic inflammatory myopathies -IIM). Schorzenie to ma podłoże autoimmunologiczne, cechuje się obecnością zmian skórnych i/lub objawami zapalenia mięśni. Wyróżnia się tzw. klasyczną postać DM, postać dziecięcą DM oraz paraneoplastyczną DM, DM indukowane lekami i DM bez zaję-cia mięśni. Ostatnio obserwuje się dynamiczny postęp w identyfikacji nowych autoprzeciwciał towarzyszących poszczególnym odmianom DM, w tym anty-TIF1, anty-NXP2, anty-SAE czy anty-MDA5. Prawdopodobnie w niedalekiej przyszłości przyczyni się on do zwiększenia częstości rozpoznawania DM i jego poszczególnych odmian, lepszej stratyfikacji pacjentów pod względem ryzyka zajęcia poszczególnych narządów wewnętrznych oraz wpłynie na całościową poprawę wyników leczenia. Obecnie glikokortykosteroidy są podstawą terapii DM, jednak wprowadzenie do lecznictwa szeregu nowych leków immunomodulujących i immunosupresyjnych, w tym leków biologicznych, wiąże się ze znaczącym zwiększeniem przeżywalności pacjentów z tą chorobą. W niniejszej pracy dokonano przeglądu piśmiennictwa na temat najnowszych trendów w diagnostyce i leczeniu DM. AbStrActDermatomyositis (DM) is one of the so-called idiopathic inflammatory myopathies (IIM). Dermatomyositis is an autoimmune disorder characterized by the presence of cutaneous lesions and/or symptoms of muscle involvement with the following variants: the "classic" variant of DM, juvenile DM, paraneoplastic DM, drug-induced DM and amyopathic DM. Dynamic discoveries of novel autoantibodies, including anti-TIF1, anti-NXP2, anti-SAE or anti-MDA5, related to certain DM variants, have been described in recent years. It seems that these antibodies will contribute to better recognition of DM and its particular variants, a better risk stratification for predicting internal organ involvement, and to a global improvement of treatment outcome. Corticosteroids remain the mainstay of DM therapy, but new immunomodulatory and immunosuppressive agents, including biologicals, resulted in a significant increase of the survival rate of DM patients. Here, we review the current literature data on DM with special emphasis on new trends in its diagnostics and treatment.

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Section: Przeciwciała Anty-mda5 (Anty-cadm-140)unclassified

Special papers Diagnostic and therapeutic advances in dermatomyositis

Samotij¹,

Szczęch²,

Reich³

2015

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“…We read with great interest the recent systematic review and meta-analysis by Trallero-Araguás et al on the relationship between the anti-p155 autoantibody and cancerassociated myositis (1). By using the pooled sensitivity and specificity of the selected 6 studies, the authors concluded that the diagnostic odds ratio (OR) for anti-p155 was 27.26 (95% confidence interval [95% CI] 6.59-112.82), the positive likelihood ratio was 6.79 (95% CI 4.11-11.23), and the negative likelihood ratio was 0.25 (95% CI 0.08-0.76).…”

Section: To the Editormentioning

confidence: 99%

Anti‐p155 autoantibodies as a diagnostic marker for cancer‐associated dermatomyositis: Comment on the article by Trallero‐Araguás et al

Rhee¹,

Baker²

2012

Arthritis & Rheumatism

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We read with great interest the recent systematic review and meta-analysis by Trallero-Araguás et al on the relationship between the anti-p155 autoantibody and cancerassociated myositis (1). By using the pooled sensitivity and specificity of the selected 6 studies, the authors concluded that the diagnostic odds ratio (OR) for anti-p155 was 27.26 (95% confidence interval [95% CI] 6.59-112.82), the positive likelihood ratio was 6.79 (95% CI 4.11-11.23), and the negative likelihood ratio was 0.25 (95% CI 0.08-0.76).While these findings are impressive, we believe the results should be interpreted with caution. The validity and usefulness of a meta-analysis depends largely on the appropriate inclusion of small and similar studies to improve statistical power. A major limitation of this methodologic approach is that findings can be greatly compromised by publication biasthe concept that small studies are more likely to be published if a significant association was identified. Small studies require a larger effect size to meet statistical significance, resulting in bias in the estimated effect sizes. In this study, the authors constructed a funnel-plot and determined that the slope coefficient was not statistically significant (P ϭ 0.15), thereby concluding that no publication bias existed. However, this deserves further exploration.We evaluated for publication bias according to the recommendations of the study by Deeks et al (2) that is referenced by Trallero-Araguás and colleagues. Deeks et al recommend formally evaluating for publication bias and sample size effects using a funnel-plot of the log OR against the inverse of the square root of the effective sample size followed by testing for asymmetry using related regression or rank correlation tests. Notably, statistical power is considered inadequate for these tests when fewer than 10 studies are included in the analysis (3), as is the case for the study by TralleroAraguás and colleagues. Therefore, the P values should be deemphasized.After graphing the funnel-plot (Figure 1), we found suggestions of asymmetry. The results from the recommended regression analysis (R 2 ϭ 0.24, P ϭ 0.3) suggest that 24% of the observed between-study differences in the diagnostic OR were due to between-study differences in sample sizes (i.e., smaller studies with greater effect sizes). This does not seem trivial. In addition, we performed a rank correlation test and found the Spearman's rho to be 0.77 with a P value approaching significance (P ϭ 0.07). Although the results of these tests for asymmetry were not statistically significant, the likelihood of a Type I error cannot be ignored given the small number of included studies and the magnitude of the associations.Based on the asymmetry seen in the funnel-plot, we used the "trim and fill" method to further characterize the possible effect of publication bias (3). By imputing values for the hypothesized missing counterparts on the left side of the funnel-plot to create a symmetric funnel shape, we evaluated for the effect of potentia...

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“…These include antibodies against PL7, PL12, OJ, EJ, KS, Ha, Zo Anti-Mi2 antibodies [Targoff and Reichlin, 1985] These have been described over 25 years ago and have been linked with classic dermatomyositis rashes. There may be a link with ultraviolet irradiation in their development Anti-p155/140 (TIF1-γ) [Trallero-Araguás et al 2012;Muro et al 2012;Saroh et al 2012] These antibodies were first described in 2006/2007. They are linked with cancer-associated myositis.…”

Section: Antibody and References Detailsmentioning

confidence: 99%

Latest advances in connective tissue disorders

Rao

Bowman

2013

Therapeutic Advances in Musculoskeletal

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Systemic lupus erythematosus Systemic lupus erythematosus (SLE) typically affects women (circa 9:1 female:male ratio) in the 16-55 age group [Ballou et al. 1982]. It is commoner among patients of African/Afro-Caribbean, South Asian or Chinese/other Asian ethnic groups. It ranges from a mild to a lifethreatening or fatal disorder [Petri et al. 2012a]. Active disease is associated with raised anti-dsDNA antibodies and reduced levels of complement C3 and/or C4 levels. Current therapy is, in fact, very effective for most patients. In mild to moderate disease, hydroxychloroquine is now commonly used as steroid-sparing therapy for all patients. For patients with active disease, corticosteroids are at the heart of current therapy, often combined with steroid sparing agents such as azathioprine, methotrexate, leflunomide, ciclosporin or mycophenolate. In patients with severe or life-threatening renal, nervous system or pulmonary disease, oral or pulsed intravenous cyclophosphamide has been typically used over the past 20 years [Boumpas et al. 1992]. As a consequence, the survival rate for SLE has steadily increased. In a review of this topic [Urowitz et al. 2008] the authors point out that since the 1950s, SLE has changed from a disease with a 50% mortality at 5 years to one of over 90% 5-year survival. The challenge, in recent years, has been less about finding drugs with greater efficacy than corticosteroids and cyclophosphamide and more about developing drug regimes with lower toxicity. Corticosteroids, in particular, have been associated with higher rates of infection, cardiovascular and bone disease [Ruiz-Irastorza et al. 2012; Petri et al 2012b]. Cyclophosphamide is associated

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Usefulness of anti‐p155 autoantibody for diagnosing cancer‐associated dermatomyositis: A systematic review and meta‐analysis

Cited by 298 publications

References 53 publications

Special papers Diagnostic and therapeutic advances in dermatomyositis

Special papers Diagnostic and therapeutic advances in dermatomyositis

Anti‐p155 autoantibodies as a diagnostic marker for cancer‐associated dermatomyositis: Comment on the article by Trallero‐Araguás et al

Latest advances in connective tissue disorders

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