Comparison of clinical features between patients with anti-synthetase syndrome and dermatomyositis: results from the MYONET registry
Author:
Hum Ryan Malcolm12ORCID, Lilleker James B13ORCID, Lamb Janine A4ORCID, Oldroyd Alexander G S12ORCID, Wang Guochun5, Wedderburn Lucy R6ORCID, Diederichsen Louise P7, Schmidt Jens8, Danieli Maria Giovanna9, Oakley Paula10, Griger Zoltan11ORCID, Nguyen Thi Phuong Thuy12ORCID, Kodishala Chanakya1314ORCID, Vazquez-Del Mercado Monica15ORCID, Andersson Helena16, De Paepe Boel17ORCID, De Bleecker Jan L17, Maurer Britta18, McCann Liza19, Pipitone Nicolo20, McHugh Neil2122ORCID, New Robert Paul23, Ollier William E24, Krogh Niels Steen25, Vencovsky Jiri26ORCID, Lundberg Ingrid E2728ORCID, Chinoy Hector129ORCID, D’Hose Sophie, Lu Xin, Tian Xiaolan, Mann Heřman, Kryštůfková Olga, Pleštilová Lenka, Klein Martin, Barochová Tereza, Kubínová Kateřina, Gelardi Chiara, Paladini Alberto, Piga Mario Andrea, Jara Luis J, Saavedra Miguel A, Cruz-Reyes Claudia V, Vera-Lastra Olga, Andrade-Ortega Lilia, Medrano-Ramírez Gabriel, Satoh Minoru, Salazar-Páramo Mario, Chavarría-Ávila Efrain, Aguilar-Vazquez Andrea, Anda Jesus-Aureliano Robles-de, Petri Marcelo H, Molberg Øyvind, Dastmalchi Maryam, Notarnicola Antonella, Gheorghe Karina, Rönnelid Johan, Liden Maria, Hanna Balsam, Jalal Awat, Hellström Helena, Martineus Jehns Christian, Lan Nguyen Thi Ngoc, Padyukov Leonid, New Paul, Platt Hazel, Rothwell Simon, Ahmed Yasmeen, Armstrong Raymond, Bernstein Robert, Black Carol, Bowman Simon, Bruce Ian, Butler Robin, Carty John, Chattopadhyay Chandra, Chelliah Easwaradhas, Clarke Fiona, Dawes Peter, Denton Christopher, Devlin Joseph, Edwards Christopher, Emery Paul, Fordham John, Fraser Alexander, Gaston Hill, Gordon Patrick, Griffiths Bridget, Gunawardena Harsha, Hall Frances, Hanna Michael, Harrison Beverley, Hay Elaine, Hilton-Jones David, Horden Lesley, Isaacs John, Isenberg David, Jones Adrian, Kamath Sanjeet, Kennedy Thomas, Kitas George, Klimiuk Peter, Knights Sally, Lambert John, Lanyon Peter, Laxminarayan Ramasharan, Lecky Bryan, Luqmani Raashid, Machado Pedro, Marks Jeffrey, Martin Michael, McGonagle Dennis, McHugh Neil, McKenna Francis, McLaren John, McMahon Michael, McRorie Euan, Merry Peter, Miles Sarah, Miller James, Nicholls Anne, Nixon Jennifer, Ong Voon, Over Katherine, Packham John, Pipitone Nicolo, Plant Michael, Pountain Gillian, Pullar Thomas, Roberts Mark, Sanders Paul, Scott David, Scott David, Shadforth Michael, Sheeran Thomas, Srinivasan Arul, Swinson David, Teh Lee-Suan, Webley Michael, Williams Brian, Winer Jonathan,
Affiliation:
1. Centre for Musculoskeletal Research, Division of Musculoskeletal & Dermatological Sciences, The University of Manchester Faculty of Biology Medicine and Health , Manchester, UK 2. The University of Manchester, National Institute for Health Research Manchester Biomedical Research Centre , Manchester, UK 3. Northern Care Alliance NHS Foundation Trust, Manchester Centre for Clinical Neuroscience, Salford Royal Hospital , Salford, UK 4. Division of Population Health, Health Services Research and Primary Care, The University of Manchester Faculty of Biology Medicine and Health, Epidemiology and Public Health Group , Manchester, UK 5. Department of Rheumatology, China-Japan Friendship Hospital , Beijing, China 6. Great Ormond Street Hospital for Children NHS Foundation Trust, Infection, Immunity and Inflammation , London, UK 7. Center for Rheumatology and Spine Diseases, Copenhagen University Hospital , Copenhagen, Denmark 8. Department of Neurology, University Medical Center Göttingen , Göttingen, Germany 9. Clinica Medica, Dipartimento di Scienze Cliniche e Molecolari, Universita Politecnica delle Marche , Ancona, Italy 10. Myositis UK , Southampton, UK 11. Department of Immunology, University of Debrecen , Debrecen, Hajdú-Bihar, Hungary 12. Internal Medicine Department, Hanoi Medical University , Hanoi, Vietnam 13. Clinical Immunology and Rheumatology, St John's National Academy of Health Sciences , Bangalore, Karnataka, India 14. Department of Rheumatology, Mayo Clinic , Rochester, MN, USA 15. Division de Medicina Interna, Servicio de Reumatologia, Hospital Civil Dr. Juan I. Menchaca, Universidad de Guadalajara , Guadalajara, Jalisco, Mexico 16. Department of Rheumatology, Oslo University Hospital , Oslo, Norway 17. Department of Neurology, Universitair Ziekenhuis Gent , Ghent, Belgium 18. Department of Rheumatology and Immunology, Inselspital University Hospital Bern , Bern, Switzerland 19. Department of Rheumatology, Alder Hey Children's NHS Foundation Trust , Liverpool, UK 20. Department of Rheumatology, Arcispedale Santa Maria Nuova di Reggio Emilia , Reggio Emilia, Emilia-Romagna, Italy 21. Department of Rheumatology, Royal National Hospital for Rheumatic Diseases , Bath, UK 22. Department of Pharmacy and Pharmacology, University of Bath , Bath, UK 23. MRC/ARUK Institute of Ageing and Chronic Disease, University of Liverpool , Liverpool, UK 24. Faculty of Science and Engineering, Manchester Metropolitan University , Manchester, UK 25. Zitelab Aps , Copenhagen, Denmark 26. Institute of Rheumatology and Department of Rheumatology, Charles University , Praha, Czech Republic 27. Division of Rheumatology, Department of Medicine, Karolinska Institutet , Stockholm, Sweden 28. Department of Gastroenterology, Dermatology, and Rheumatology, Karolinska University Hospital , Stockholm, Sweden 29. Northern Care Alliance NHS Foundation Trust, Department of Rheumatology, Salford Royal Hospital , Salford, UK
Abstract
Abstract
Objectives
To compare clinical characteristics, including the frequency of cutaneous, extramuscular manifestations and malignancy, between adults with anti-synthetase syndrome (ASyS) and DM.
Methods
Using data regarding adults from the MYONET registry, a cohort of DM patients with anti-Mi2/-TIF1γ/-NXP2/-SAE/-MDA5 autoantibodies, and a cohort of ASyS patients with anti-tRNA synthetase autoantibodies (anti-Jo1/-PL7/-PL12/-OJ/-EJ/-Zo/-KS) were identified. Patients with DM sine dermatitis or with discordant dual autoantibody specificities were excluded. Sub-cohorts of patients with ASyS with or without skin involvement were defined based on presence of DM-type rashes (heliotrope rash, Gottron’s papules/sign, violaceous rash, shawl sign, V-sign, erythroderma, and/or periorbital rash).
Results
In total 1054 patients were included (DM, n = 405; ASyS, n = 649). In the ASyS cohort, 31% (n = 203) had DM-type skin involvement (ASyS-DMskin). A higher frequency of extramuscular manifestations, including Mechanic’s hands, Raynaud’s phenomenon, arthritis, interstitial lung disease and cardiac involvement differentiated ASyS-DMskin from DM (all P < 0.001), whereas higher frequency of any of four DM-type rashes—heliotrope rash (n = 248, 61% vs n = 90, 44%), violaceous rash (n = 166, 41% vs n = 57, 9%), V-sign (n = 124, 31% vs n = 28, 4%), and shawl sign (n = 133, 33% vs n = 18, 3%)—differentiated DM from ASyS-DMskin (all P < 0.005). Cancer-associated myositis (CAM) was more frequent in DM (n = 67, 17%) compared with ASyS (n = 21, 3%) and ASyS-DMskin (n = 7, 3%) cohorts (both P < 0.001).
Conclusion
DM-type rashes are frequent in patients with ASyS; however, distinct clinical manifestations differentiate these patients from classical DM. Skin involvement in ASyS does not necessitate increased malignancy surveillance. These findings will inform future ASyS classification criteria and patient management.
Funder
European Union Sixth Framework Programme European Science Foundation
Publisher
Oxford University Press (OUP)
Subject
Pharmacology (medical),Rheumatology
Cited by
6 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献
|
|