Coexisting of anti-Ro52 autoantibodies on anti-MDA5 autoantibodies-positive dermatomyositis is highly associated with rapidly progressive interstitial lung disease and mortality risk
Abstract
Objective Interstitial lung disease (ILD) is a common extramuscular complication contributing to significant morbidity and mortality in anti-melanoma differentiation associated gene 5 positive dermatomyositis (anti-MDA5+ DM). We conducted this study to investigate the association of anti-Ro52 antibodies with clinical characteristics and prognosis in anti-MDA5+ DM patients.
Methods We assessed a cohort of 246 patients with anti-MDA5+ DM. To calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for RP-ILD and death while controlling for potential confounders, variables selected by univariate COX regression analysis were included in a multivariate COX regression model with the stepwise forward selection method. A 2-tailed p value <0.05 was considered to indicate statistical significance.
Results 246 anti-MDA5+ DM patients were enrolled, 70 cases male, with an average age of 53.10±12.35 years. Anti-Ro52 coexisted in 64.22% (158/246) patients. Anti- Ro52 autoantibodies positive anti-MDA5+ DM patients had a higher rate of RP-ILD (log-rank p<0.001) and a higher mortality rate (log-rankp=0.010). For anti-MDA5+ DM patients with positive anti-Ro52 antibodies, patients with a short disease course, and high inflammation are at increased risk of RP-ILD and death. The appearance of the active rash is an independent protective factor of death.
Conclusion Anti-Ro52 antibodies are highly prevalent in anti-MDA5+ DM patients and their coexistence correlates with a higher rate of RP-ILD and mortality. Patients with a short disease course, increased inflammation and without rash are more likely to have a poor prognosis.