Antisynthetase Syndrome with Anti-Jo1 Antibodies in 48 Patients: Pulmonary Involvement Predicts Disease-modifying Antirheumatic Drug Use
The Journal of Rheumatology, 08/10/2012
Stanciu R et al. – The study outlines the burden of chest involvement for the prognosis of antisynthetase syndrome in terms of patients’ requirement for disease–modifying antirheumatic drug therapy.Methods
- Forty-eight patients (33 women, 15 men) who were anti-Jo1-positive referred to one center between 1998 and 2008 were analyzed retrospectively.
- The median age of disease onset was 43 years [interquartile range (IQR) 33–53 yrs].
- The median followup was 5 years (IQR 2-8 yrs).
- At diagnosis, 81% of patients presented with myositis, 80% ILD, 77% arthralgia, 48% RP, and 21% mechanic’s hands.
- During the followup, 14 patients (29%) had no need for DMARD, while 34 (71%) required DMARD.
- Patients with mechanic’s hands (p = 0.02) and higher creatine phosphokinase at diagnosis (median 6070 IU/l vs 1121 IU/l; p = 0.002) were more likely to need DMARD.
- ILD, noted on computed tomography scan by a nonspecific interstitial pneumonia score, was lower in the group of patients with no DMARD need (4 vs 7; p = 0.04).
- Twenty patients (44%) presented with a pulmonary aggravation (worsening of radiologic score of ILD and/or pulmonary function test results) leading to DMARD use.
- Nonspecific interstitial pneumonia score (7 vs 5; p = 0.05) and total lung volume (57.5% vs 70%; p = 0.02) values predicted pulmonary aggravation.