Clinical features and prognosis of idiopathic inflammatory myopathies with coexistent multiple myositis-specific antibodies
Authors' conclusion
Multiple MSAs coexist in some IIM patients and their existence indicates mixed features from concomitant MSAs in anti-MDA5+ population and anti-ARS+ population.
Study context
- Population
- Adult patients with idiopathic inflammatory myopathies (IIM)
- Participants
- 202 consecutive patients
- Exposure
- IIM with vs without multiple MSAs
- Multiple MSAsn = 44
- Outcome
- Clinical features and survival rates, with vs without multiple MSAs
Methodological detailsconsecutive patients, multivariable Cox regression
- Consecutive patients
- Multivariable Cox regression
Main finding
As reported in the abstract
Prevalence of multiple MSAs
Multiple MSAs
21.8%
44
- Among multiple MSAs: anti-ARS+
- 63.6%
- Among multiple MSAs: anti-MDA5+
- 52.3%
Observational data: associations, not effects.
Further findings
| Outcome | HR for death (mortality) (95% CI) | P value | |
|---|---|---|---|
| Survival, anti-MDA5+ population (subgroup)Multiple MSAsvs Without multiple MSAsMultivariable Cox regression; independent protective factor | 0.108 (0.013–0.908) | P = 0.041 | |
| 0.050.21520HR for death (mortality) (log scale) |
| Outcome | P value |
|---|---|
| Survival, anti-MDA5+ population (subgroup)Multiple MSAs vs Without multiple MSAs | P = 0.003 |
Antibody profile among the 44 patients with multiple MSAs
- Anti-ARS+
- 63.6%
- Anti-MDA5+
- 52.3%
Clinical features, anti-MDA5+ population (subgroup)
- Multiple MSAs associated with less rapidly progressive interstitial lung disease (RP-ILD), fever, rash, periungual erythema, more muscle involvement and dysphagia, higher albumin level, and higher positive rate of ANA
Clinical features, anti-ARS+ population (subgroup)
- Multiple MSAs: more V-neck sign, skin ulcers, dysphagia and peripheral edema
Survival, overall and anti-ARS+ populations
- No differences in survival rates between patients with or without multiple MSAs
Original publication
Clinical features and prognosis of idiopathic inflammatory myopathies with coexistent multiple myositis-specific antibodies. Clin Exp Rheumatol. Published 29 December 2023. doi:10.
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