Clinical Characteristics of New-onset Dermatomyositis with Adverse Outcomes: a retrospective cohort study

Abstract

Abstract Objectives Identification of characteristics and risk factors of new-onset dermatomyositis patients with recurrent aggravation after regular treatment. Methods In this cohort study, clinical characteristics of 142 new-onset dermatomyositis patients were analyzed. We defined three different clinical outcomes after long-term follow-up: mild, aggravation, and death. The clinical presentation of patients with recurrent aggravations was primarily analyzed and discussed in this cohort. The decision tree algorithm was used to predict the outcomes. Results In this corhort, there were 72 in the mild group, 56 in the aggravation group (39 were single aggravation and 17 were multiple aggravations), 14 in the death group. The median time point for patients to experience their first aggravation was 40 weeks after initial treatment, the median interval between multiple aggravations was 32 weeks, and for anti-MDA5 positive patients, the median interval was 16 weeks. Symptoms of aggravation were generally manifested as progression of pulmonary interstitial lesions, or extended skin rashes. Baseline CRP and CK levels were higher in the multiple aggravations or death group. Conclusions DM patients tended to aggravate after glucocorticoid was regular reduced to approximately the lowest maintenance dose. Higher baseline CRP and CK levels have a certain predictive effect on adverse outcomes in DM.