Evidence mapPaperPMID 37541740Full record

SynthesisRMD open2023

Rheumatoid factor isotypes in rheumatoid arthritis diagnosis and prognosis: a systematic review and meta-analysis.

Francesca Motta, Nicola Bizzaro, Davide Giavarina, Franco Franceschini, Maria Infantino, Boaz Palterer, Gian Domenico Sebastiani, Carlo Selmi

Open access · goldAbstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
9.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. [Quality management in the rheumatology laboratory].Zeitschrift fur Rheumatologie · 2026
    Article
  6. Article
  7. Article
  8. Review
  9. Review
  10. Targeting the Neonatal Fc Receptor in Autoimmune Diseases: Pipeline and Progress.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2025
    Review
  11. Review
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
  17. Article
  18. Review
  19. Article
  20. Autoantibodies Serum Level and 10-Year Risk of Fractures Evaluated by FRAXOpen access rheumatology : research and reviews · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 7 institutions in 2 countries.

Francesca MottaDivision of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, Italy.ORCID 0000-0002-8093-2734
Nicola BizzaroLaboratory of Clinical Pathology, Azienda Sanitaria Universitaria Integrata, Udine, Italy nic.bizzaro@gmail.com.ORCID 0000-0002-4227-6983
Davide GiavarinaDepartment of Laboratory Medicine, St Bortolo Hospital, Vicenza, Italy.
Franco FranceschiniDepartment of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Maria InfantinoLaboratory of Immunology and Allergology, Ospedale San Giovanni di Dio, Firenze, Italy.ORCID 0000-0002-6200-4467
Boaz PaltererDepartment of Clinical and Experimental Medicine, University of Florence, Firenze, Italy.
Gian Domenico SebastianiRheumatology, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy.
Carlo SelmiDivision of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, Italy.ORCID 0000-0002-0323-0376
Humanitas University · ITAzienda Ospedaliera San Camillo-Forlanini · ITAzienda Sanitaria Universitaria Integrata di Trieste · ITBrescia University · USNuovo Ospedale San Giovanni di Dio · ITOspedale San Bortolo · ITUniversity of Florence · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe first biomarker associated with the rheumatoid arthritis is rheumatoid factor (RF) and since the earliest reports a role has been proposed in the diagnosis and in the prediction of clinical features and outcome. The study of RF isotypes has further attempted to improve diagnostic accuracy and identify specific subgroups of patients. The main objective of this study is to provide an analysis of the literature on the role of RF isotypes in the diagnosis and prognosis of rheumatoid arthritis (RA).

methodsWe performed a systematic literature review and meta-analysis on the role of RF isotypes in RA (only in English, from PubMed, search terms: "rheumatoid factor isotypes", "diagnosis", "prognosis" and "rheumatoid arthritis", last search 31 July 2022, two independent assessment of quality and biases, results included in tables and in the meta-analysis).

resultsThirty-six articles were examined (7517 patients). Testing all RF isotypes with latex test or nephelometry allows for the highest sensitivity (68.6%, 95% CI 66.2% to 71.0%); nonetheless, the determination of IgA isotype provides the highest specificity (91.4%, 95% CI 90.8% to 92.0%) and the highest positive likelihood ratio (7.7, 95% CI 5.7 to 10.4). When testing IgM isotype the highest diagnostic OR (21.7, 95% CI 16.1 to 29.3) is reached. When analysing anti-citrullinated protein antibodies, RF isotype determination increases diagnostic accuracy. On the other hand, these do not provide relevant prognostic information, as results are conflicting.

conclusionsTesting RF allows the highest sensitivity, while IgA isotype the highest specificity and positive likelihood ratio for RA diagnosis. On the other hand, determination of RF isotypes dose not allow prognostic information, as data are limited and heterogeneous.

Indexed as

Arthritis, RheumatoidRheumatoid FactorAnti-Citrullinated Protein AntibodiesHumansImmunoglobulin AImmunoglobulin IsotypesAnti-Citrullinated Protein AntibodiesImmunoglobulin AImmunoglobulin IsotypesRheumatoid Factorarthritis, rheumatoidautoantibodiesrheumatoid factor

Identifiers

PMID37541740
PMCPMC10407415
OpenAlexW4385575447

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.