{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:55:09Z","timestamp":1781585709537,"version":"3.54.5"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Rheumatoid arthritis (RA) diagnosis remains challenging due to the limitations of conventional biomarkers. This network meta-analysis (NMA) aimed to compare the diagnostic performance of seven novel biomarkers for RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched EMBASE, PubMed, and Cochrane databases, identifying 1,713 records. Twelve studies met inclusion criteria. Diagnostic accuracy metrics (sensitivity, specificity, log diagnostic odds ratio [lnDOR]) were extracted. A frequentist NMA was performed using the netmeta package in R, with biomarkers ranked via P-scores against the ACR\/EULAR RA criteria. Heterogeneity, transitivity, and publication bias were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Anti-carbamylated protein (Anti-CarP) antibody showed the highest diagnostic efficacy (P-score = 0.80; sensitivity 62 \u2013 64%, specificity 89%), followed by anti-mutated citrullinated vimentin (Anti-MCV; P-score = 0.69). miR- 146a and power Doppler ultrasound (PDUS) demonstrated moderate performance (P-scores 0.46 and 0.45), while 14-3-3 \u03b7 protein (P-score = 0.26) and its combination with ACPA (P-score = 0.07) ranked lowest. The network exhibited a star-shaped geometry with no significant inconsistency or publication bias (Egger \u2018s test p = 0.52).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Anti-CarP and Anti-MCV are the most promising diagnostic biomarkers for RA, Anti-CarP and Anti-MCV are the most promising diagnostic biomarkers for RA. Their potential utility in seronegative or early-stage RA warrants further investigation. The limited performance of 14-3-3 \u03b7 challenges prior assumptions about its utility. Standardized thresholds and direct comparisons are needed for validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1728804","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:28:31Z","timestamp":1781584111000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Network meta-analysis of novel diagnostic biomarkers for rheumatoid arthritis: comparative performance of anti-CarP, anti-MCV, and emerging markers"],"prefix":"10.3389","volume":"17","author":[{"given":"Guanghui","family":"Li","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Immunology, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manxiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.131446","article-title":"Serum 14-3-3\u03b7 is a novel marker that complements current serological measurements to enhance detection of patients with rheumatoid arthritis","volume":"41","author":"Maksymowych","year":"2014","journal-title":"J Rheumatol"},{"key":"B2","article-title":"Detection of high levels of 2 specific isoforms of 14-3\u20133 proteins in synovial fluid from patients with joint inflammation","volume":"34","author":"Kilani","year":"2007","journal-title":"J Rheumatol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204154","article-title":"Anti-carbamylated protein antibodies precede the onset of rheumatoid arthritis","volume":"73","author":"Shi","year":"2014","journal-title":"Ann Rheum Dis"},{"key":"B4","article-title":"Anti-CarP antibody in rheumatoid arthritis","volume-title":"BMJ Journals","author":"Brink","year":"2018"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1186\/ar2570","article-title":"Antibodies to mutated citrullinated vimentin for diagnosing rheumatoid arthritis in anti-CCP-negative patients and for monitoring infliximab therapy","volume":"10","author":"Nicaise-Roland","year":"2008","journal-title":"Arthritis Res Ther"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.4078\/jkra.2007.14.3.235","article-title":"Comparison of anti-mutated citrullinated vimentin with anti-cyclic citrullinated peptide and rheumatoid factors for the diagnostic value of rheumatoid arthritis","volume":"14","author":"Song","year":"2007","journal-title":"J Korean Rheum Assoc"},{"key":"B7","article-title":"14-3-3\u03b7 + ACPA combination for rheumatoid arthritis diagnosis","volume-title":"Front Immunol.","author":"Alessandri","year":"2022"},{"key":"B8","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1186\/s13075-020-02190-3","article-title":"Serum calprotectin: a promising biomarker in rheumatoid arthritis and axial spondyloarthritis","volume":"22","author":"Jarlborg","year":"2020","journal-title":"Arthritis Res Ther"},{"key":"B9","article-title":"Plasma calprotectin in rheumatoid arthritis","volume-title":"Arthritis","author":"Guo","year":"2022"},{"key":"B10","article-title":"Serum miR-146a in rheumatoid arthritis","author":"Luo","year":"2019"},{"key":"B11","volume-title":"Joint ultrasound PD \u2265 Grade 2 in rheumatoid arthritis [provisional Vancouver entry based on uploaded Table\u00a01]","author":"Wakefield","year":"2004"},{"key":"B12","volume-title":"Joint ultrasound power Doppler in rheumatoid arthritis","author":"Hammer","year":"2013"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1728804\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:28:45Z","timestamp":1781584125000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1728804\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":12,"alternative-id":["10.3389\/fimmu.2026.1728804"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1728804","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]},"article-number":"1728804"}}