POS1185 PERFORMANCE OF ADENOSIN DEAMINASE ACTIVITY IN SYNOVIAL FLUID FOR THE EARLY DIAGNOSIS OF TUBERCULOUS ARTHRITIS: A META-ANALYSIS

Abstract

BackgroundAdenosin deaminase activity (ADA) has shown good performance in diagnosing pleural, peritoneal and meningeal tuberculosis. Still, the performance of ADA activity in synovial fluid for the diagnosis of tuberculous arthritis has received less attention.ObjectivesTo analyze the performance of ADA in synovial fluid to diagnosis tuberculous artrhritis.MethodsWe research Medline and EMBASE from the inception to October 2021 and the American College of Rheumatology and European League Against Rheumatism for conference abstracts (2012-2021) to assess the accuracy of ADA activity in synovial fluid compared to a composite reference standard (necrotizing granulomas in a synovial biopsy; acid-fast stain, Mycobacterium culture or RT-PCR assay for tuberculosis and/or clinical response to tuberculosis treatment) to early diagnosis tuberculous arthritis. We performed meta-analysis using a random-effects model and evaluated the sources of heterogeneity via subgroup analysis and meta-regression.ResultsSeven independent studies (N= 307 subjects) that compared ADA activity in synovial fluid with the composite reference standard were included. The pooled sensitivity and specificity of ADA activity was 0.939 (95% confidence Interval [CI], 0,873-0,977; heterogeneity p=0.297; I2=17.4%) and 0.885 (95% confidence Interval [CI], 0.833-0.925; heterogeneity p=0.002; I2=85.3%) compared to the composite reference standard, respectively. The random-effects model for pooled diagnostic Odds Ratio was 74.582 (95% CI, 19.826-280.57; heterogeneity p=0.133; I2=38.8%). The receiver operating characteristic curve area was 0.9617 (95% CI, 0.925-1.000). Meta-regression did not identify the type of study (prospective or retrospective), country of publication, type de assay, or cut-off value as sources of heterogeneity.ConclusionMeasuring adenosine deaminase activity in synovial fluid demonstrates good performance for the early diagnosis joint tuberculosis.AcknowledgementsEl estudio fue apoyado con una beca de investigación de la Asociación para la Investigación en Reumatología de la Marina Baixa (AIRE-MB)Disclosure of InterestsNone declared