PT - JOURNAL ARTICLE AU - RALUCA STANCIU AU - MARGUERITE GUIGUET AU - LUCILE MUSSET AU - DIANE TOUITOU AU - CATHERINE BEIGELMAN AU - AUDE RIGOLET AU - NATHALIE COSTEDOAT-CHALUMEAU AU - YVES ALLENBACH AU - BAPTISTE HERVIER AU - ODILE DUBOURG AU - THIERRY MAISONOBE AU - JEAN-LUC CHARUEL AU - ANTHONY BEHIN AU - SERGE HERSON AU - ZAHIR AMOURA AU - PHILIPPE GRENIER AU - OLIVIER BENVENISTE TI - Antisynthetase Syndrome with Anti-Jo1 Antibodies in 48 Patients: Pulmonary Involvement Predicts Disease-modifying Antirheumatic Drug Use AID - 10.3899/jrheum.111604 DP - 2012 Sep 01 TA - The Journal of Rheumatology PG - 1835--1839 VI - 39 IP - 9 4099 - http://www.jrheum.org/content/39/9/1835.short 4100 - http://www.jrheum.org/content/39/9/1835.full SO - J Rheumatol2012 Sep 01; 39 AB - Objective. To analyze the characteristics, outcomes, and predictive factors of disease-modifying antirheumatic drug (DMARD) use in 48 patients with antisynthetase syndrome [characterized by myositis, interstitial lung disease (ILD), arthritis, Raynaud’s phenomenon (RP), and/or mechanic’s hands] and the presence of anti-histidyl-transfer RNA synthetase (anti-Jo1) autoantibodies. Methods. Forty-eight patients (33 women, 15 men) who were anti-Jo1-positive referred to one center between 1998 and 2008 were analyzed retrospectively. Results. The median age of disease onset was 43 years [interquartile range (IQR) 33–53 yrs]. The median followup was 5 years (IQR 2–8 yrs). At diagnosis, 81% of patients presented with myositis, 80% ILD, 77% arthralgia, 48% RP, and 21% mechanic’s hands. During the followup, 14 patients (29%) had no need for DMARD, while 34 (71%) required DMARD. Patients with mechanic’s hands (p = 0.02) and higher creatine phosphokinase at diagnosis (median 6070 IU/l vs 1121 IU/l; p = 0.002) were more likely to need DMARD. ILD, noted on computed tomography scan by a nonspecific interstitial pneumonia score, was lower in the group of patients with no DMARD need (4 vs 7; p = 0.04). Twenty patients (44%) presented with a pulmonary aggravation (worsening of radiologic score of ILD and/or pulmonary function test results) leading to DMARD use. Nonspecific interstitial pneumonia score (7 vs 5; p = 0.05) and total lung volume (57.5% vs 70%; p = 0.02) values predicted pulmonary aggravation. Conclusion. Our study outlines the burden of chest involvement for the prognosis of antisynthetase syndrome in terms of patients’ requirement for DMARD therapy.