Anticitrullinated protein/peptide antibodies (ACPAs) have shown valuable effects in the diagnosis of rheumatoid arthritis (RA). Both fibrinogen and vimentin are significant antigens of ACPAs. This study evaluated the diagnostic performance of fibrinogen and vimentin peptides in RA.
We searched the PubMed, Embase, and Cochrane Library databases for studies published in English until January 2019 that evaluated the utility of the peptides of both vimentin and fibrinogen. The bivariate mixed-effects model and summary receiver operating characteristic (SROC) curve were used to estimate sensitivity and specificity across studies.
Seven peptides from 19 studies were included. The pooled sensitivities of Fibα36-50, Fibα563-583, Fibα580-600, Fibα621-635, Fibβ36-52, Fibβ60-74, and Vim60-75 were 35%, 41%, 18%, 26%, 0.53%, 57%, and 44%, respectively. The pooled specificities of Fibα36-50, Fibα563-583, Fibα580-600, Fibα621-635, Fibβ36-52, Fibβ60-74, and Vim60-75 were 97%, 98%, 98%, 98%, 97%, 98%, and 98%, respectively. The SROC areas under the curve (AUCs) of Fibα36-50, Fibα563-583, Fibα580-600, Fibα621-635, Fibβ36-52, Fibβ60-74, and Vim60-75 were 0.92, 0.85, 0.64, 0.82, 0.91, 0.96, and 0.86, respectively.
Both fibrinogen and vimentin peptides have a high specificity but a relatively low sensitivity in diagnosing RA. The diagnostic accuracies of Fibβ60-74 and Fibβ36-52 were better than those of Vim60-75, Fibα36-50, and Fibα563-583, and all of them were better than that of Fibα621-635 and Fibα580-600.Key Points• Our study summarized the diagnostic accuracy of peptides derived from fibrinogen and vimentin and evaluated the diagnostic value of different peptides for RA patients.• Both fibrinogen and vimentin peptides have a high specificity but a relatively low sensitivity in diagnosing RA.