J Rheumatol 2022 Jun 15. Epub 2022 Jun 15.
Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China; Department of Rheumatology and Immunology, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China; Department of Rheumatology, Huai'an First People's Hospital, Huai'an, Jiangsu, China; Department of Rheumatology, The First People's Hospital of Changzhou, Changzhou, Jiangsu, China; Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China; Department of Rheumatology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, China; Department of Rheumatology, Changzhou No.2 People's Hospital, Changzhou, Jiangsu, China; Department of Rheumatology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China; Department of Rheumatology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China; Department of Rheumatology, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China; Department of Rheumatology, Nanjing First Hospital, Nanjing, Jiangsu, China; Department of Rheumatology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China; Department of Rheumatology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China; Department of Rheumatology, Yancheng No.1 People's Hospital, Yancheng, Jiangsu, China; Department of Rheumatology, Zhongda Hospital Southeast University, Nanjing, Jiangsu, China; Department of Rheumatology, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian, Jiangsu, China; Department of Rheumatology, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China; Department of Rheumatology, Wuxi No.2 People's Hospital, Wuxi, Jiangsu, China; Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, China, Nanjing, Jiangsu, China. Chengyin Lv and Hanxiao You are joint first authors and contributed equally to this work. Wenfeng Tan and Miaojia Zhang contributed equally to this work. Correspondence to Dr. Wenfeng Tan and Miaojia Zhang, Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;
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 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 <0.001) and a higher mortality rate (log-rank=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.