Short-Term and Long-Term Outcome of Anti-Jo1-Positive Patients with Anti-Ro52 Antibody

• Published in: Seminars in arthritis and rheumatism 2012-06, Vol.41 (6), p.890-899
• Main Authors: Marie, Isabelle, MD, PhD, Hatron, Pierre Yves, MD, PhD, Dominique, Stéphane, MD, Cherin, Patrick, MD, PhD, Mouthon, Luc, MD, PhD, Menard, Jean-François, MD, Levesque, Hervé, MD, PhD, Jouen, Fabienne, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; anti-Jo1 antibody; anti-R052 antibody; antisynthetase syndrome; Autoantibodies - blood; Autoantibodies - immunology; Biological and medical sciences; cancer; Diseases of the osteoarticular system; Female; Histidine-tRNA Ligase - immunology; Humans; interstitial lung disease; Lung Diseases, Interstitial - blood; Lung Diseases, Interstitial - complications; Lung Diseases, Interstitial - immunology; Male; Medical sciences; Middle Aged; Muscle Weakness - blood; Muscle Weakness - immunology; Myositis - blood; Myositis - complications; Myositis - immunology; outcome; Pneumology; Prognosis; prognostic factors; Respiratory system : syndromes and miscellaneous diseases; Retrospective Studies; Rheumatology; Ribonucleoproteins - immunology
• ISSN: 0049-0172; 1532-866X
• DOI: 10.1016/j.semarthrit.2011.09.008

Objectives The aims of the present study were to (1) assess clinical features and long-term outcome in anti-Jo1-positive patients with anti-Ro52 antibody; (2) compare characteristics of anti-Jo1-positive patients with and without anti-Ro52 antibody; and (3) compare features of anti-Ro52-positive patients with and without anti-Jo1 antibody. Methods The medical records of 89 consecutive anti-Jo1-positive patients with antisynthetase syndrome (ASS) were reviewed; 36 of these patients had coexistent anti-Ro52 antibody. Furthermore, the medical records of 13 consecutive anti-Ro52-positive patients without anti-Jo1 antibody were also reviewed. Results Nine anti-Jo1-positive patients (25%) with anti-Ro-52 antibody achieved remission of ASS, whereas 19 other patients (52.8%) improved and 8 patients (22.2%) worsened their clinical status. Anti-Jo1-positive patients with anti-Ro52 antibody experienced ASS-related complications: interstitial lung disease ( n = 28), esophageal dysfunction ( n = 9), and joint manifestations ( n = 25), including periarticular hydroxyapatite calcifications and erosions of metacarpophalangeal and interphalangeal joints and wrists ( n = 3); 7 anti-Ro52-positive patients (19.4%) had cancer. Anti-Jo1-positive patients with anti-Ro52 antibody, compared with those without, more commonly experienced deterioration of myositis and joint involvement, symptomatic form of ILD, and cancer; they also had decreased survival rate ( P = 0.05). We further found that anti-Ro52-positive patients with anti-Jo1 antibody, compared with those without, were younger and more frequently exhibited ILD with poorer prognosis. Conclusions Our series underlines that the presence of anti-Ro52 antibody is associated with a particular phenotype of ASS, leading to more severe myositis and joint impairment. Moreover, the coexistence of anti-Ro52 antibody seems to be associated with an increased risk of cancer. We therefore suggest that anti-Jo1-positive patients should routinely undergo the search for anti-Ro52 antibody, as this autoantibody appears to impact patients' prognosis.