多生物标志物疾病活动评分与类风湿关节炎疾病活动指标的相关性：系统评价和荟萃分析。
Correlation of the Multi-Biomarker Disease Activity Score With Rheumatoid Arthritis Disease Activity Measures: A Systematic Review and Meta-Analysis.
机构信息
University of Nebraska Medical Center and Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha.
University of Utah, Salt Lake City.
出版信息
Arthritis Care Res (Hoboken). 2019 Nov;71(11):1459-1472. doi: 10.1002/acr.23785.
OBJECTIVE
There are conflicting reports on the validity of the multi-biomarker disease activity (MBDA) score for assessing rheumatoid arthritis (RA) disease activity. Our aim was to perform a systematic review of the MBDA and a meta-analysis of the correlation between the MBDA and other RA disease activity measures.
METHODS
A systematic review was performed by searching Medline, Embase, Scopus, Google Scholar, and the Cochrane Library from inception to March 7, 2017. Study details, MBDA performance, and study quality were assessed by independent reviewers. Correlations of the MBDA with composite RA disease activity measures were pooled using random-effects meta-analyses.
RESULTS
A total of 22 studies were identified in the systematic review, of which 8 (n = 3,242 assays) reported correlations of the MBDA with RA disease activity measures. Pooling results from these 8 studies in the meta-analysis, the MBDA demonstrated modest correlations with the Disease Activity Score in 28 joints using the C-reactive protein level (DAS28-CRP; r = 0.41, 95% confidence interval [95% CI] 0.36-0.46) and the Disease Activity Score using the erythrocyte sedimentation rate (DAS28-ESR; r = 0.48, 95% CI 0.38-0.58), with weaker correlations observed with the Simplified Disease Activity Index (SDAI; r = 0.35, 95% CI 0.26-0.43), Clinical Disease Activity Index (CDAI; r = 0.26, 95% CI 0.19-0.33), and Routine Assessment of Patient Index Data 3 (RAPID3; r = 0.23, 95% CI 0.19-0.27). Correlations between change in MBDA and change in disease activity measures ranged from r = 0.53 for the DAS28-ESR to r = 0.26 for the CDAI.
CONCLUSION
The MBDA demonstrates moderate convergent validity with the DAS28-CRP and the DAS28-ESR but weaker correlations with the SDAI, CDAI, and RAPID3. While it appears to complement existing RA disease activity measures, further assessment of the performance characteristics of the MBDA is warranted.
目的
关于多生物标志物疾病活动（MBDA）评分评估类风湿关节炎（RA）疾病活动的有效性，存在相互矛盾的报告。我们的目的是对 MBDA 进行系统评价，并对 MBDA 与其他 RA 疾病活动测量之间的相关性进行荟萃分析。
方法
通过检索 Medline、Embase、Scopus、Google Scholar 和 Cochrane 图书馆，从建库至 2017 年 3 月 7 日，进行系统评价。由独立的审查员评估研究详情、MBDA 性能和研究质量。使用随机效应荟萃分析汇总 MBDA 与综合 RA 疾病活动测量之间的相关性。
结果
在系统评价中确定了 22 项研究，其中 8 项（n=3242 项检测）报告了 MBDA 与 RA 疾病活动测量之间的相关性。对这些 8 项研究的荟萃分析结果进行汇总，MBDA 与使用 C 反应蛋白水平的 28 关节疾病活动评分（DAS28-CRP；r=0.41，95%置信区间[95%CI]0.36-0.46）和使用红细胞沉降率的 DAS28-ESR（r=0.48，95%CI 0.38-0.58）之间存在适度相关性，与简化疾病活动指数（SDAI；r=0.35，95%CI 0.26-0.43）、临床疾病活动指数（CDAI；r=0.26，95%CI 0.19-0.33）和患者常规评估数据 3（RAPID3；r=0.23，95%CI 0.19-0.27）之间的相关性较弱。MBDA 变化与疾病活动测量变化之间的相关性范围从 DAS28-ESR 的 r=0.53 到 CDAI 的 r=0.26。
结论
MBDA 与 DAS28-CRP 和 DAS28-ESR 具有中等的收敛有效性，但与 SDAI、CDAI 和 RAPID3 的相关性较弱。虽然它似乎补充了现有的 RA 疾病活动测量方法，但需要进一步评估 MBDA 的性能特征。
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