Refractory cutaneous ulcers in anti-MDA5 dermatomyositis were not associated with rapidly progressive interstitial lung disease, and responded to tadalafil
Authors' conclusion
This study found that ulcerative rash in anti-MDA5 DM may not be associated with RP-ILD. The results also suggest that tadalafil may be a useful therapy for refractory cutaneous ulcers.
Study context
- Population
- Consecutive dermatomyositis (DM) patients with anti-MDA5 antibody62 (75.6 %) female
- Participants
- 82 patients
- Exposure
- Anti-MDA5 DM with cutaneous ulcers vs without skin ulcers; tadalafil added for refractory cutaneous ulcers
- Ulcern = 26
- Refractory ulcers + tadalafiln = 10
- Outcome
- Features of ulcer vs non-ulcer patients (univariate)
Methodological detailsconsecutive cases, univariate analysis
- Consecutive cases
- Univariate analysis
Main finding
As reported in the abstract
Ulcer
31.7 %
26
- Gottron's sign more frequent in ulcer patients
- P = 0.026
- Perlungual erythematosus more frequent in ulcer patients
- P = 0.007
- Arthritis more frequent in ulcer patients
- P = 0.031
- Shortness of breath after exercise more likely in non-skin ulcer patients
- P = 0.027
- Rapidly progressive ILD (RP-ILD) more likely in non-skin ulcer patients
- P = 0.024
Observational data: associations, not effects.
Further findings
- Improvement in physician global assessment (PGA), CDASI and p-VAS after tadalafil added (refractory ulcers) · within one to two months — Refractory ulcers + tadalafil
- 80 %
- Improvement in PGA, CDASI and p-VAS after tadalafil added (refractory ulcers) — Refractory cutaneous ulcers completely resolved after treatment (patients)
- 5
Interstitial lung disease (ILD) and RP-ILD in anti-MDA5 DM
%
- ILD
- 95.0
- RP-ILD
- 45.1
- Approximately
Original publication
Refractory cutaneous ulcers in anti-MDA5 dermatomyositis were not associated with rapidly progressive interstitial lung disease, and responded to tadalafil. Semin Arthritis Rheum. Published 31 January 2025. doi:10.
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