RT Journal Article
SR Electronic
T1 Coexistence of Anti-Ro52 Antibodies in Anti-MDA5 Antibody–Positive Dermatomyositis Is Highly Associated With Rapidly Progressive Interstitial Lung Disease and Mortality Risk
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.220139
DO 10.3899/jrheum.220139
A1 Lv, Chengyin
A1 You, Hanxiao
A1 Xu, Lingxiao
A1 Wang, Lei
A1 Yuan, Fenghong
A1 Li, Ju
A1 Wu, Min
A1 Zhou, Shiliang
A1 Da, Zhanyun
A1 Qian, Jie
A1 Wei, Hua
A1 Yan, Wei
A1 Zhou, Lei
A1 Wang, Yan
A1 Yin, Songlou
A1 Zhou, Dongmei
A1 Wu, Jian
A1 Lu, Yan
A1 Su, Dinglei
A1 Liu, Zhichun
A1 Liu, Lin
A1 Ma, Longxin
A1 Xu, Xiaoyan
A1 Zang, Yinshan
A1 Liu, Huijie
A1 Ren, Tianli
A1 Wang, Fang
A1 Zhang, Miaojia
A1 Tan, Wenfeng
YR 2022
UL http://www.jrheum.org/content/early/2022/10/10/jrheum.220139.abstract
AB Objective Interstitial lung disease (ILD) is a common extramuscular complication contributing to significant morbidity and mortality in patients with dermatomyositis (DM) who are positive for antimelanoma differentiation–associated gene 5 antibody (anti-MDA5+). We conducted this study to investigate the association of anti-Ro52 antibodies with clinical characteristics and prognosis in patients with anti-MDA5+ DM. Methods We assessed a cohort of 246 patients with anti-MDA5+ DM. To calculate hazard ratios and 95% CIs for rapidly progressive ILD (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 analysis with P < 0.05 was considered to be statistically significant. Results A total of 246 patients with anti-MDA5+ DM were enrolled; 70 patients were male, and the patient group had an average age of 53.1 (12.4) years. Anti-Ro52 was present in 64.2% (158/246) patients. Patients with anti-MDA5+ DM who were positive for anti-Ro52 had a higher rate of RP-ILD (log-rank P < 0.001) and a higher mortality rate (log-rank P = 0.01). For patients with anti-MDA5+ DM who were positive for anti-Ro52, those with a short disease course and high inflammation were at increased risk of RP-ILD and death. The appearance of active rash was an independent protective factor of death. Conclusion Anti-Ro52 antibodies were highly prevalent in patients with anti-MDA5+ DM, and their coexistence correlated with a higher rate of RP-ILD and mortality. Patients with a short disease course, with increased inflammation, and without rash were more likely to have a poor prognosis.