Abstract
Objective:
To evaluate the analytical performance of commercial myositis-specific autoantibody (MSA) assays against immunoprecipitation (IP) assays.
Methods:
A systematic literature search was conducted in PubMed, Web of Science, and Scopus through July 2024. Data were extracted on study design, participant characteristics, index tests, and 2 × 2 contingency tables for diagnostic performance. Study quality was assessed using the QUADAS-2 tool. Sensitivity and specificity were calculated for each dataset and presented as paired forest plots and summary receiver operating characteristic (SROC) curves. A hierarchical SROC model was used to estimate pooled sensitivity and specificity for meta-analysis.
Results:
Of 3156 articles, 23 met inclusion criteria and were judged to have low risk of bias across all QUADAS-2 domains. The most frequently evaluated commercial assay was the line blot assay (LBA; 16 studies), followed by enzyme immunoassay (EIA; 9 studies). In the meta-analyses, the highest pooled sensitivity was observed for anti-MDA5 with EIA (95.7 %), followed by anti-SAE with LBA (88.3 %), anti-PL-12 with LBA (87.2 %), and anti-Jo-1 and anti-MDA5 with LBA (82.8 %). Lower sensitivities were observed for anti-Mi-2 (67.4 %), anti-NXP2 (69.7 %), and anti-TIF1-γ (63.8 %) with LBA. Pooled specificity ranged from 94.7 % to 99.3 % across MSA assays, but a false-positive result was a common concern for LBA, except for anti-EJ.
Conclusion:
False-positive and false-negative results remain a significant challenge in the use of commercial MSA assays.
| Original language | English |
|---|---|
| Article number | 152858 |
| Journal | Seminars in Arthritis and Rheumatism |
| Volume | 75 |
| Early online date | 27 Oct 2025 |
| DOIs | |
| Publication status | Published - 1 Dec 2025 |
Bibliographical note
Publisher Copyright:© 2025 Elsevier Inc. All rights reserved.
Keywords
- Humans
- Autoantibodies/blood
- Myositis/immunology
- Immunoprecipitation
- Sensitivity and Specificity
- Reference Standards
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