多生物标志物疾病活动评分：监测类风湿关节炎的客观工具？系统评价和荟萃分析。
Multibiomarker disease activity score: an objective tool for monitoring rheumatoid arthritis? A systematic review and meta-analysis.
机构信息
Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
出版信息
Rheumatology (Oxford). 2023 Jun 1;62(6):2048-2059. doi: 10.1093/rheumatology/keac715.
OBJECTIVES
The multibiomarker disease activity (MBDA) score is an objective tool for monitoring disease activity in RA. Here we report a systematic review and meta-analysis of the clinical value of the MBDA score in RA.
METHODS
We performed a systematic literature search in five medical databases-MEDLINE (via PubMed), Cochrane Library (CENTRAL), Embase, Scopus and Web of Science-from inception to 13 October 2021. Original articles reporting on the performance of the MBDA score's correlation with conventional disease activity measures or the predictive and discriminative values of the MBDA score for radiographic progression, therapy response, remission and relapse were included.
RESULTS
Our systematic search provided a total of 1190 records. After selection and citation searches, we identified 32 eligible studies. We recorded moderate correlations between MBDA score and conventional disease activity measures at baseline [correlation (COR) 0.45 (CI 0.28, 0.59), I2 = 71.0% for the 28-joint DAS with CRP (DAS28-CRP) and COR 0.55 (CI 0.19, 0.78), I2 = 0.0% for DAS28 with ESR] and at follow-up [COR 0.44 (CI 0.28, 0.57, I2 = 70.0% for DAS28-CRP) and found that the odds of radiographic progression were significantly higher for patients with a high baseline MBDA score (>44) than for patients with a low baseline MBDA score (<30) [OR 1.03 (CI 1.02-1.05), I2 = 10.0%].
CONCLUSION
The MBDA score might be used as an objective disease activity marker. In addition, it is also a reliable prognostic marker of radiographic progression.
目的
多生物标志物疾病活动（MBDA）评分是监测类风湿关节炎（RA）疾病活动的一种客观工具。在此，我们报告了一项关于 MBDA 评分在 RA 中的临床价值的系统评价和荟萃分析。
方法
我们在五个医学数据库中进行了系统的文献检索，包括 MEDLINE（通过 PubMed）、Cochrane 图书馆（CENTRAL）、Embase、Scopus 和 Web of Science，检索时间从建库至 2021 年 10 月 13 日。纳入报告 MBDA 评分与传统疾病活动指标相关性、MBDA 评分对放射学进展、治疗反应、缓解和复发的预测和鉴别价值的原始文章。
结果
我们的系统检索共提供了 1190 条记录。经过筛选和引文检索，我们确定了 32 项符合条件的研究。我们记录了 MBDA 评分与基线时传统疾病活动指标之间的中度相关性[相关性（COR）0.45（CI 0.28，0.59），28 关节 C 反应蛋白（DAS28-CRP）的 DAS28 为 71.0%，I2=71.0%；ESR 的 DAS28 为 0.55（CI 0.19，0.78），I2=0.0%]和随访时的相关性[COR 0.44（CI 0.28，0.57，DAS28-CRP 的 I2=70.0%），我们发现基线 MBDA 评分较高（>44）的患者发生放射学进展的可能性明显高于基线 MBDA 评分较低（<30）的患者[比值比（OR）1.03（CI 1.02-1.05），I2=10.0%]。
结论
MBDA 评分可用作客观疾病活动标志物。此外，它还是放射学进展的可靠预后标志物。
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