title: Anti-cyclic citrullinated peptide antibody as a marker of erosive arthritis in patients with systemic lupus erythematosus: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Anti-cyclic citrullinated peptide (CCP) antibody is an established marker in the diagnosis and prognostication of rheumatoid arthritis (RA). Infrequently, systemic lupus erythematosus (SLE) patients also develop a deforming erosive arthritis, similar to that of RA. Our objective was to determine whether anti-CCP antibody is a useful marker of erosive disease in SLE patients presenting with arthritis.
  
  
  METHODS
  Electronic databases EMBASE, MEDLINE and non-indexed MEDLINE citations were searched through April 11, 2014, using the outlined key terms. Studies meeting predefined inclusion and exclusion criteria were reviewed. Two reviewers independently assessed the quality of included articles using previously described criteria. The DerSimonian-Laird random effects model was used to calculate pooled sensitivity and specificity of anti-CCP antibody for erosive arthritis in SLE.
  
  
  RESULTS
  Seven articles met inclusion and exclusion criteria. A total of 609 SLE patients with arthritis were identified, 70 of whom had erosive disease. Pooled sensitivity and specificity of anti-CCP antibody for erosive arthritis was 47.8% (95% CI, 26.2%-70.2%) and 91.8% (95% CI, 78.4%-97.2%), respectively.
  
  
  CONCLUSIONS
  Our findings suggest that anti-CCP antibody is a highly specific marker for erosive arthritis in SLE. Longitudinal prospective studies are needed to determine if anti-CCP antibody can be used as a predictor of erosive disease.
authors.affiliation: Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Budhram
authors.affiliation: Mississauga Academy of Medicine, University of Toronto, Mississauga, Ontario, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Chu
authors.affiliation: Peters-Boyd Academy, University of Toronto, Toronto, Ontario, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Rusta-Sallehy
authors.affiliation: Division of Rheumatology, McMaster University, Hamilton, Ontario, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Ioannidis
authors.affiliation: Division of Clinical Immunology & Allergy, McMaster University, Hamilton, Ontario, Canada.
authors.forename: J A
authors.initials: JA
authors.lastname: Denburg
authors.affiliation: Division of Rheumatology, McMaster University, Hamilton, Ontario, Canada.
authors.forename: J D
authors.initials: JD
authors.lastname: Adachi
authors.affiliation: Division of Rheumatology, McMaster University, Hamilton, Ontario, Canada Division of Clinical Immunology & Allergy, McMaster University, Hamilton, Ontario, Canada haaland@mcmaster.ca.
authors.forename: D A
authors.initials: DA
authors.lastname: Haaland
mesh_terms: D001168:Arthritis / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D001323:Autoantibodies / Q000276:immunology; D015415:Biomarkers / Q000378:metabolism; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D010456:Peptides, Cyclic / Q000276:immunology*; D011379:Prognosis; D012680:Sensitivity and Specificity
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide
keywords: Anti-cyclic citrullinated peptide antibody; arthritis; systemic lupus erythematosus