Assessment of anti-MDA5 antibody as a diagnostic biomarker in patients with dermatomyositis-associated interstitial lung disease or rapidly progressive interstitial lung disease

// Liubing Li 1, * , Qian Wang 1, * , Xiaoting Wen 1, * , Chenxi Liu 1, * , Chanyuan Wu 1 , Funing Yang 1, 2 , Xiaofeng Zeng 1 and Yongzhe Li 1 1 Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China 2 Department of Medical Laboratory, The First Hospital of Jilin University, Changchun, China * These authors have contributed equally to this work Correspondence to: Yongzhe Li, email: yongzhelipumch@126.com Keywords: anti-MDA5, dermatomyositis, ILD, RPILD, diagnosis Received: March 13, 2017      Accepted: June 17, 2017      Published: July 06, 2017 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.