Clinical features of dermatomyositis associated with anti-MDA5 antibodies by age
Koichi Yamaguchi, Aya Yamaguchi, Yuji Onuki, Miki Itai, Chiharu Kashiwagi, Kazutaka Takehara, Shuhei Aoki, Azusa Kanaya, Kohei Taguchi, Kazue Umetsu, Kazuma Oshima, Megumi Uchida, Hayato Kimura, Morimitsu Kasahara, Masao Takemura, Kenichiro Hara, Akiko Sekiguchi, Sei‐ichiro Motegi, Yoshinao Muro, Masao Nakasatomi, Rena Motohashi, Toru Sakairi, Junichi Nakagawa, Keiju Hiromura, Masaru Obokata, Masahiko Kurabayashi, Toshitaka Maeno
Abstract
OBJECTIVES: Anti-melanoma differentiation-associated gene 5 (MDA5) autoantibody-positive and age at onset ≥60 years are poor prognosis factors in polymyositis (PM) and dermatomyositis (DM) associated with interstitial lung disease (ILD) among Japanese patients. However, the influence of age on the clinical features of anti-MDA5 autoantibody-positive patients with DM remains unclear. METHODS: We retrospectively examined 40 patients with DM and anti-MDA5 autoantibodies according to age. We compared patients aged <60 and ≥60 years with respect to clinical features including laboratory test findings, high-resolution lung computed tomography data, treatment content, and complications such as infections and prognosis. We also examined clinical features between surviving and deceased patients in the older patient group. RESULTS: = .02) complicated with rapidly progressive ILD (RP-ILD), combination immunosuppressive therapy, and strictly controlled infections. CONCLUSION: Clinical features and mortality of anti-MDA5 autoantibody-positive DM patients were influenced by age. Patients aged ≥60 years had a worse prognosis, and combination immunosuppressive therapy was often ineffective for RP-ILD in older patients.