Lupus & antiphospholipid syndrome
Clinical utility of a multianalyte lupus risk score incorporating cell-bound complement activation products: a systematic evaluation
Authors' conclusion
The MAP index integrating CB-CAPs demonstrated markedly superior diagnostic accuracy and generalisability compared with conventional serological tests alone.
Study context
- Population
- Individuals from US clinical cohorts, 2011–2025: SLE meeting 1997 American College of Rheumatology (ACR) classification criteria, healthy controls and disease controls1,210 SLE, 687 healthy, 1235 disease controls
- Participants
- 3,132 individuals
- Comparison
- Multianalyte Assay Panel (MAP) index integrating cell-bound complement activation products (CB-CAPs) vs CB-CAPs alone, anti-double-stranded DNA (anti-dsDNA)/Smith and complement C3/C4
- Outcome
- Diagnostic accuracy (DOR, likelihood ratios (LRs), sensitivity/specificity) for SLE
Methodological detailssystematic analysis, multiple US clinical cohorts
- Systematic analysis
- Multiple US clinical cohorts
Performance
As reported in the abstract
DOR vs healthy controls
| Test or model | DOR |
|---|---|
| MAP index | 105.0 |
| CB-CAPs alone | 56.8 |
| anti-dsDNA/Smith | 31.8 |
| C3/C4 | 8.2 |
DOR
MAP index105.0
CB-CAPs alone56.8
anti-dsDNA/Smith31.8
C3/C48.2
Further findings
| Outcome | MAP index | CB-CAPs alone | anti-dsDNA/Smith | C3/C4 | OR | P value |
|---|---|---|---|---|---|---|
| DOR vs disease controls | ||||||
| DOR | 22.3 | 20.3 | 13.7 | 8.8 | ||
| Likelihood ratios | ||||||
| LR+ | 33.7 | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | ||
| LR- | 0.3 | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | ||
| Sensitivity within SLE cohortMAP index vs anti-dsDNA | 27.5 | all adjusted p<0.001 | ||||
| Sensitivity within SLE cohortMAP index vs B lymphocyte-bound C4d | 20.8 | all adjusted p<0.001 | ||||
| Sensitivity within SLE cohortMAP index vs erythrocyte-bound C4d | 14.6 | all adjusted p<0.001 |
— not stated in the abstract
- DOR vs disease controls: abstract prints: performance of CB-CAPs alone, anti-dsDNA/Smith and C3/C4 remained superior (DOR=22.3 vs 20.3, 13.7 and 8.8)
Likelihood ratios
- MAP index yielded the highest LR+ and lowest LR-
Additional SLE cases identified vs conventional markers
- More SLE cases identified than conventional markers (serologies and complement)
- 24.5%
- Patients with negative serologies and normal complement, reduced from
- 52.0%
- Patients with negative serologies and normal complement, reduced to
- 27.5%
Original publication
Clinical utility of a multianalyte lupus risk score incorporating cell-bound complement activation products: a systematic evaluation. Lupus Sci Med. Published 29 May 2026. doi:10.
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