@article {Stanciujrheum.111604, author = {Raluca Stanciu and Marguerite Guiguet and Lucile Musset and Diane Touitou and Catherine Beigelman and Aude Rigolet and Nathalie Costedoat-Chalumeau and Yves Allenbach and Baptiste Hervier and Odile Dubourg and Thierry Maisonobe and Jean-Luc Charuel and Anthony Behin and Serge Herson and Zahir Amoura and Philippe Grenier and Olivier Benveniste}, title = {Antisynthetase Syndrome with Anti-Jo1 Antibodies in 48 Patients: Pulmonary Involvement Predicts Disease-modifying Antirheumatic Drug Use}, elocation-id = {jrheum.111604}, year = {2012}, doi = {10.3899/jrheum.111604}, publisher = {The Journal of Rheumatology}, abstract = {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{\textquoteright}s phenomenon (RP), and/or mechanic{\textquoteright}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{\textendash}53 yrs]. The median followup was 5 years (IQR 2{\textendash}8 yrs). At diagnosis, 81\% of patients presented with myositis, 80\% ILD, 77\% arthralgia, 48\% RP, and 21\% mechanic{\textquoteright}s hands. During the followup, 14 patients (29\%) had no need for DMARD, while 34 (71\%) required DMARD. Patients with mechanic{\textquoteright}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{\textquoteright} requirement for DMARD therapy.}, issn = {0315-162X}, URL = {https://www.jrheum.org/content/early/2012/07/26/jrheum.111604}, eprint = {https://www.jrheum.org/content/early/2012/07/26/jrheum.111604.full.pdf}, journal = {The Journal of Rheumatology} }