Clinical characteristics and prognosis of anti-MDA5 antibody positive dermatomyositis patients with secondary interstitial lung disease

Objective To analyze the clinical characteristics and prognostic factors of anti-melanoma differentiation-associated gene 5 (MDA5)-positive dermatomyositis (DM) patients with secondary interstitial lung disease (ILD). Methods A retrospective collection was conducted on 97 patients with DM-ILD admitt...

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Main Authors: MA Zongbo, ZHAO Cheng, QIN Fang, CHEN Zhanrui, PAN Dongmei, ZENG Wen, LIAO Xiaoling, LEI Ling
Format: Article
Language:zho
Published: Editorial Office of Journal of Guangxi Medical University 2024-12-01
Series:Guangxi Yike Daxue xuebao
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Online Access:https://journal.gxmu.edu.cn/article/doi/10.16190/j.cnki.45-1211/r.2024.12.007
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author MA Zongbo
ZHAO Cheng
QIN Fang
CHEN Zhanrui
PAN Dongmei
ZENG Wen
LIAO Xiaoling
LEI Ling
author_facet MA Zongbo
ZHAO Cheng
QIN Fang
CHEN Zhanrui
PAN Dongmei
ZENG Wen
LIAO Xiaoling
LEI Ling
author_sort MA Zongbo
collection DOAJ
description Objective To analyze the clinical characteristics and prognostic factors of anti-melanoma differentiation-associated gene 5 (MDA5)-positive dermatomyositis (DM) patients with secondary interstitial lung disease (ILD). Methods A retrospective collection was conducted on 97 patients with DM-ILD admitted to the First Affiliated Hospital of Guangxi Medical University from January 2018 to December 2022. They were divided into anti-MDA5 positive group and anti-MDA5 negative group. The clinical characteristics and survival rate of the two groups were compared, and the influencing factors of prognosis were analyzed. Results Compared with the anti-MDA5 negative group, the disease duration of the anti-MDA5 positive group was shorter, the proportion of chest tightness, rapid progress (RP)-ILD, pulmonary infection and skin ulcers was increased, the proportion of pulmonary arterial hypertension (PAH) was decreased, the levels of white blood cells, platelets and creatine kinase were decreased, and the serum ferritin levels were increased (all P < 0.05). Compared with the anti-MDA5 negative group, the proportions of combination of two immunosuppressants, use of gamma globulin and the first use of antibiotics during hospitalization were higher in the anti-MDA5 positive group (all P < 0.05). With a median follow-up of 17.5 months, the overall mortality rate of anti-MDA5 positive group was 45.5%, and the 6-month, 12-month and 36-month survival rates were 61.43%, 58.57% and 55.71%, respectively. Cox regression analysis showed that the risk factors for the prognosis of anti-MDA5 positive ILD were RP-ILD, Velcro rales and elevated carcinoembryonic antigen (CEA) (all P < 0.05). Conclusion Patients with anti-MDA5 positive ILD have a shorter disease duration. They are prone to skin ulcers and lung infections, have a low incidence of PAH, and have a high proportion of immunosuppressive agents combination and antibiotic use. The occurrence of RPILD, Velcro rales, and elevated CEA are risk factors for prognosis.
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publisher Editorial Office of Journal of Guangxi Medical University
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series Guangxi Yike Daxue xuebao
spelling doaj-art-1eb3965da81642f4b4f01c0dc98f751d2025-08-20T03:52:48ZzhoEditorial Office of Journal of Guangxi Medical UniversityGuangxi Yike Daxue xuebao1005-930X2024-12-0141121628163610.16190/j.cnki.45-1211/r.2024.12.007gxykdxxb-41-12-1628Clinical characteristics and prognosis of anti-MDA5 antibody positive dermatomyositis patients with secondary interstitial lung diseaseMA Zongbo0ZHAO Cheng1QIN Fang2CHEN Zhanrui3PAN Dongmei4ZENG Wen5LIAO Xiaoling6LEI Ling7Department of Rheumatology and Immunology, the First People's Hospital of Nanning, Nanning 530022, ChinaDepartment of Rheumatology and Immunology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, ChinaDepartment of Rheumatology and Immunology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, ChinaDepartment of Rheumatology and Immunology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, ChinaDepartment of Rheumatology and Immunology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, ChinaDepartment of Rheumatology and Immunology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, ChinaDepartment of Rheumatology and Immunology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, ChinaDepartment of Rheumatology and Immunology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, ChinaObjective To analyze the clinical characteristics and prognostic factors of anti-melanoma differentiation-associated gene 5 (MDA5)-positive dermatomyositis (DM) patients with secondary interstitial lung disease (ILD). Methods A retrospective collection was conducted on 97 patients with DM-ILD admitted to the First Affiliated Hospital of Guangxi Medical University from January 2018 to December 2022. They were divided into anti-MDA5 positive group and anti-MDA5 negative group. The clinical characteristics and survival rate of the two groups were compared, and the influencing factors of prognosis were analyzed. Results Compared with the anti-MDA5 negative group, the disease duration of the anti-MDA5 positive group was shorter, the proportion of chest tightness, rapid progress (RP)-ILD, pulmonary infection and skin ulcers was increased, the proportion of pulmonary arterial hypertension (PAH) was decreased, the levels of white blood cells, platelets and creatine kinase were decreased, and the serum ferritin levels were increased (all P < 0.05). Compared with the anti-MDA5 negative group, the proportions of combination of two immunosuppressants, use of gamma globulin and the first use of antibiotics during hospitalization were higher in the anti-MDA5 positive group (all P < 0.05). With a median follow-up of 17.5 months, the overall mortality rate of anti-MDA5 positive group was 45.5%, and the 6-month, 12-month and 36-month survival rates were 61.43%, 58.57% and 55.71%, respectively. Cox regression analysis showed that the risk factors for the prognosis of anti-MDA5 positive ILD were RP-ILD, Velcro rales and elevated carcinoembryonic antigen (CEA) (all P < 0.05). Conclusion Patients with anti-MDA5 positive ILD have a shorter disease duration. They are prone to skin ulcers and lung infections, have a low incidence of PAH, and have a high proportion of immunosuppressive agents combination and antibiotic use. The occurrence of RPILD, Velcro rales, and elevated CEA are risk factors for prognosis.https://journal.gxmu.edu.cn/article/doi/10.16190/j.cnki.45-1211/r.2024.12.007anti-melanoma differentiation-associated gene 5dermatomyositisinterstitial lung diseaseclinical characteristicsprognosis
spellingShingle MA Zongbo
ZHAO Cheng
QIN Fang
CHEN Zhanrui
PAN Dongmei
ZENG Wen
LIAO Xiaoling
LEI Ling
Clinical characteristics and prognosis of anti-MDA5 antibody positive dermatomyositis patients with secondary interstitial lung disease
Guangxi Yike Daxue xuebao
anti-melanoma differentiation-associated gene 5
dermatomyositis
interstitial lung disease
clinical characteristics
prognosis
title Clinical characteristics and prognosis of anti-MDA5 antibody positive dermatomyositis patients with secondary interstitial lung disease
title_full Clinical characteristics and prognosis of anti-MDA5 antibody positive dermatomyositis patients with secondary interstitial lung disease
title_fullStr Clinical characteristics and prognosis of anti-MDA5 antibody positive dermatomyositis patients with secondary interstitial lung disease
title_full_unstemmed Clinical characteristics and prognosis of anti-MDA5 antibody positive dermatomyositis patients with secondary interstitial lung disease
title_short Clinical characteristics and prognosis of anti-MDA5 antibody positive dermatomyositis patients with secondary interstitial lung disease
title_sort clinical characteristics and prognosis of anti mda5 antibody positive dermatomyositis patients with secondary interstitial lung disease
topic anti-melanoma differentiation-associated gene 5
dermatomyositis
interstitial lung disease
clinical characteristics
prognosis
url https://journal.gxmu.edu.cn/article/doi/10.16190/j.cnki.45-1211/r.2024.12.007
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