Coexistence of Anti-Ro52 Antibodies in Anti-MDA5 Antibody-Positive Dermatomyositis Is Highly Associated With Rapidly Progressive Interstitial Lung Disease and Mortality Risk

• Published in: Journal of rheumatology 2023-02, Vol.50 (2), p.219-226
• Main Authors: Lv, Chengyin, You, Hanxiao, Xu, Lingxiao, Wang, Lei, Yuan, Fenghong, Li, Ju, Wu, Min, Zhou, Shiliang, Da, Zhanyun, Qian, Jie, Wei, Hua, Yan, Wei, Zhou, Lei, Wang, Yan, Yin, Songlou, Zhou, Dongmei, Wu, Jian, Lu, Yan, Su, Dinglei, Liu, Zhichun, Liu, Lin, Ma, Longxin, Xu, Xiaoyan, Zang, Yinshan, Liu, Huijie, Ren, Tianli, Wang, Fang, Zhang, Miaojia, Tan, Wenfeng
• Format: Article
• Language: English
• Subjects: Autoantibodies; Dermatomyositis - complications; Disease Progression; Female; Humans; Inflammation - complications; Interferon-Induced Helicase, IFIH1; Lung Diseases, Interstitial - etiology; Male; Middle Aged; Prognosis; Retrospective Studies
• ISSN: 0315-162X; 1499-2752
• DOI: 10.3899/jrheum.220139

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. 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 < 0.05 was considered to be statistically significant. 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 < 0.001) and a higher mortality rate (log-rank = 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. 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.