Diagnostic Value Of Anti-MDA5 Antibody For Interstitial Lung Disease In Adult Or Juvenile Dermatomyositis:A Meta-Analysis

Purpose: The current meta-analysis was performed to update the evidence on MDA5-RPILD and MDA5-ILD relationship in adult or juvenile dermatomyositis.Methods: An electronic search of PubMed,Embase,Cochrane Library was conducted from their inception to May,2017.Meta-disc1.4was used to calculate heterogeneity and obtain the pool sensitivity,specificity,positive and negative likelihood ratios,diagnostic odds ratio and SROC curve.Quality assessment and publication bias was determined by QUADAS-2 and STATA 12.0.Results: 32 studies with high quality and middle heterogeneity were used for the final data synthesis.Anti-MDA5 showed a higher diagnostic and prognostic value of RPILD(AUC=0.927,Q*=0.862),compared with chronic ILD(AUC=0.717,Q*=0.667)in DM.For diagnosing RPILD in JDM,the value(AUC=0.836,Q*=0.768)is weaker.Moreover,Detecting anti-MDA5 to predict RPILD is better in CADM(AUC=0.942,Q*=0.880)than DM(AUC=0.926,Q*=0.860),which is also more applicable to East-Asia populations(AUC=0.960,Q*=0.891)than western populations(AUC=0.928,Q*=0.863).The different detection method of anti-MDA5 implied immunoprecipitation(AUC=0.927,Q*=0.859)is not superior to ELISA(AUC=0.929,Q*=0.864).There is no publication bias according to Deek's plot.Conclusions: Anti-MDA5 antibody is a significant laboratory index for diagnosing and predicting the existence of RPILD than chronic ILD in adult DM.The diagnostic value is weaker in JDM-RPILD.The MDA5-RPILD association differs from DM types,races and detection method.