Abstract
Anti-melanoma differentiation-associated protein 5 (MDA5) antibody have been found in dermatomyositis (DM)-associated interstitial lung disease (DM-ILD) and DM-associated rapidly progressive ILD (DM-RPILD). Due to the conflicting results regarding the association between anti-MDA5 antibody and DM-ILD or DM-RPILD and the diagnostic value of this antibody for DM-ILD and DM-RPILD, we performed this meta-analysis. A systematic search was performed to identify studies published to January 14, 2017. Sixteen publications with 491 DM with ILD versus 605 DM without ILD, as well as eighteen publications with 186 DM with RPILD and 790 DM without RPILD were included. The pooled sensitivity, specificity, and area under the curve (AUC) values of anti-MDA5 antibody for DM-ILD were 0.47 (95% CI: 0.37–0.57), 0.96 (95% CI, 0.92–0.97), and 0.90 (95% CI: 0.88–0.93), respectively, with a low sensitivity value. The pooled sensitivity, specificity, and AUC values were 0.83 (95% CI: 0.77–0.88), 0.86 (95% CI: 0.80–0.91), and 0.87 (95% CI: 0.84–0.90) for DM with RPILD versus without RPILD with good sensitivity and specificity values. Trial sequential analysis showed sufficient evidence to support that anti-MDA5 antibody was associated with DM-ILD and DM-RPILD. The statistical power of this study calculated using G*Power version 3.1.9.2 was more than 99% (α = 0.05). Taken together, these findings suggest that anti-MDA5 antibody has a potential useful ability as a noninvasive biomarker in the diagnosis of RPILD in patients with DM.
Highlights
Classic dermatomyositis (CDM) and clinically amyopathic dermatomyositis (CADM) are two classifications of dermatomyositis (DM) and are characterized by the involvement of skeletal muscles, skin, and other organs, especially the lungs [1,2,3]
16 publications [12, 14,15,16,17,18,19,20,21,22,23,24,25,26,27,28] analyzing the correlation between anti-melanoma differentiation-associated protein 5 (MDA5) antibody and DM-Interstitial lung disease (ILD) and 18 publications [12, 14, 16,17,18,19,20,21,22,23,24, 29,30,31,32,33,34,35] analyzing the correlation between anti-MDA5 antibody and DM-rapidly progressive ILD (RPILD) were included in the final analysis
Diagnosis and aggressive therapy are required in DM-associated ILD (DM-ILD) and DM-RPILD to improve poor prognosis [5, 7]
Summary
Classic dermatomyositis (CDM) and clinically amyopathic dermatomyositis (CADM) are two classifications of dermatomyositis (DM) and are characterized by the involvement of skeletal muscles, skin, and other organs, especially the lungs [1,2,3]. Pulmonary Fibrosis of the American Thoracic Society and the European Respiratory Society [8], rapidly progressive ILD (RPILD) including acute/subacute interstitial pneumonia is a progressive deterioration associated with ILD within 3 months. The survival time was significantly reduced in myositis patients with RPILD [9]. Serum myositis-specific autoantibodies (MSAs) are useful markers for the diagnosis of DM and are associated with distinct clinical phenotypes [10]. One of the MSAs, www.impactjournals.com/oncotarget anti-MDA5 antibody, has been reported to be associated with DM-associated ILD (DM-ILD) with an unfavorable survival rate (90-day survival rate: 66.7%) [11]. Studies show that there are correlations of anti-MDA5 antibody with ILD [14, 15] and RPILD [16, 17] in DM patients
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