Antibody predictors of mortality and lung function trends in myositis spectrum interstitial lung disease
Authors' conclusion
Among the autoantibody profiles in myositis spectrum disorders, anti-MDA5+ and anti-PL7+ conferred higher mortality risks in patients with IIM-ILD. Survivors of an early peak of mortality in anti-MDA5+ disease appeared to have a favourable prognosis.
Study context
- Population
- Consecutive adults with IIM-ILD or IPAF positive for myositis-specific antibodies (MSAs) (IPAF-MSA), three hospitals81% met IIM criteria
- Participants
- 430 adults
- Exposure
- Autoantibody profiles vs their absence
- Outcome
- Mortality
Methodological detailsmulticentre (three hospitals), consecutive adult patients, univariate and multivariate Cox proportional hazards analyses
- Multicentre (three hospitals)
- Consecutive adult patients
- Univariate and multivariate Cox proportional hazards analyses
Main finding
As reported in the abstract
Mortality by autoantibody profile
Each group vs Anti-MDA5 negativityHazard ratio (95% CI)
MDA5+first 3 months
65.2(14.1–302.0)
MDA5+after first 3 months; no significant difference
0.55(0.14–2.28)
Anti-Jo1+multivariate
0.61(0.4–0.87)
Anti-PL7+multivariate
2.07(1.44–2.99)
- Anti-synthetase antibodies · multivariate
- HR 0.63
Observational data: associations, not effects.
Further findings
Univariate risk factors for mortality
- Higher age, Charlson Comorbidity Index and CRP; lower BMI, baseline TLCO% and FEV1%
Longitudinal %FVC trends
- Anti-MDA5+: slow improvement in %FVC over the first 3 years
- Anti-PL7+: slow decline from 12 months onwards
Original publication
Antibody predictors of mortality and lung function trends in myositis spectrum interstitial lung disease. Rheumatology (Oxford). Published 1 December 2023. doi:10.
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