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- Title
Anti-MDA5 antibody, ferritin and IL-18 are useful for the evaluation of response to treatment in interstitial lung disease with anti-MDA5 antibody-positive dermatomyositis.
- Authors
Gono, Takahisa; Sato, Shinji; Kawaguchi, Yasushi; Kuwana, Masataka; Hanaoka, Masanori; Katsumata, Yasuhiro; Takagi, Kae; Baba, Sayumi; Okamoto, Yuko; Ota, Yuko; Yamanaka, Hisashi
- Abstract
Objective. The aim of this study was to investigate the precise clinical characteristics and to analyse the association between the anti-MDA5 antibody (anti-MDA5ab) titre and disease status in patients with anti-MDA5ab-positive DM.Methods. Twenty-seven patients who presented with DM and were positive for the anti-MDA5ab were enrolled. The association between the clinical manifestations and the clinical parameters, including the anti-MDA5ab, was analysed.Results. The complication of rapidly progressive interstitial lung disease (RP-ILD) occurred in 20 (74%) patients. The frequencies of fatal outcome, relapse and malignancy were 33, 4 and 4%, respectively. Remarkably, a fatal outcome occurred within the first 6 months. Compared with six non-RP-ILD patients, elderly age at onset, severely involved pulmonary function and high levels of serum ferritin were present in 20 RP-ILD patients with anti-MDA5ab. Alveolar–arterial oxygen difference (AaDO2) ≥32 mmHg and ferritin ≥828 ng/ml at admission were poor prognostic factors in RP-ILD patients with anti-MDA5ab-positive DM. The median value of the anti-MDA5ab titre on admission was higher in patients who later died than in those who survived. The efficacy of treatment was indicated by the anti-MDA5ab, ferritin and IL-18 concentrations. The decline index of the anti-MDA5ab titre after treatment was lower in the subset of patients who died than in the subset of patients who lived. Sustained high levels of anti-MDA5ab, ferritin and IL-18 were present in the patients who died.Conclusion. Anti-MDA5ab titre and ferritin and IL-18 concentrations are useful for the evaluation of the response to treatment and the status of ILD in patients with anti-MAD5ab-positive DM.
- Subjects
INTERSTITIAL lung diseases; DERMATOMYOSITIS; BLOOD testing; IMMUNOGLOBULINS; PULMONARY function tests; RESEARCH funding; SURVIVAL; DESCRIPTIVE statistics; PROGNOSIS
- Publication
Rheumatology, 2012, Vol 51, Issue 9, p1563
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/kes102