Clinical characteristics of cancer-associated myositis complicated by interstitial lung disease: A large-scale multicentre cohort study

Yuko Kaneko, Takahiro Nunokawa, Yoshinori Taniguchi, Yukie Yamaguchi, Takahisa Gono, Kenichi Masui, Atsushi Kawakami, Yasushi Kawaguchi, Shinji Sato, Masataka Kuwana, Yutaka Okano, Naoshi Nishina, Maasa Tamura, Yohei Kirino, Kei Ikeda, Jun Kikuchi, Makoto Kubo, Yoshinori Tanino, Shinjiro Kaieda, Taio NaniwaMasaki Watanabe, Tatsuhiko Harada, Taro Ukichi, Taisuke Kazuyori, Hideto Kameda, Makoto Kaburaki, Yasuo Matsuzawa, Shunji Yoshida, Yasuko Yoshioka, Takuya Hirai, Katsuaki Asakawa, Yoko Wada, Koji Ishii, Sakuhei Fujiwara, Takeshi Saraya, Kozo Morimoto, Tetsu Hara, Hiroki Suzuki, Hideki Shibuya, Yoshinao Muro, Ryoichi Aki, Takuo Shibayama, Shiro Ohshima, Yuko Yasuda, Masaki Terada, Yoshie Kawahara

Research output: Contribution to journalArticle

Abstract

Objective: To clarify the incidence, risk factors, and impact of malignancy in patients with PM/DM-associated interstitial lung disease (ILD). Methods: This study used data from 497 patients with PM/DM-associated ILD enrolled in a multicentre, retrospective and prospective cohort of incident cases. Cancer-associated myositis (CAM) was defined as malignancy diagnosed within 3 years before or after PM/DM diagnosis. Demographic and clinical information was recorded at the time of diagnosis, and data about the occurrence of mortality and malignancy was collected. Results: CAM was identified in 32 patients with PM/DM-associated ILD (6.4%). Patients with CAM were older (64 vs 55 years, P < 0.001), presented with arthritis less frequently (24% vs 49%, P = 0.01), and showed a lower level of serum Krebs von den Lungen-6 (687 vs 820 IU/l, P = 0.03) than those without CAM. The distribution of myositis-specific autoantibodies, including anti-melanoma differentiation-associated gene 5, anti-aminoacyl tRNA synthetase, and anti-transcriptional intermediary factor 1-γantibodies, did not differ between the groups. Survival analysis demonstrated that CAM patients had a poorer survival than non-CAM patients (P = 0.006), primarily due to excess deaths by concomitant malignancy, while mortality due to ILD-related respiratory failure was similar between the groups (P = 0.51). Conclusion: Concomitant malignancy can occur in patients with PM/DM-associated ILD, and has significant impact on mortality. Older age, lack of arthritis, and a lower level of serum Krebs von den Lungen-6 at diagnosis are predictors of concomitant malignancy.

Original languageEnglish
Pages (from-to)112-119
Number of pages8
JournalRheumatology (United Kingdom)
Volume59
Issue number1
DOIs
Publication statusPublished - 2020 Jan 1

Keywords

  • cancer-associated
  • interstitial lung diseases
  • myositis

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

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    Kaneko, Y., Nunokawa, T., Taniguchi, Y., Yamaguchi, Y., Gono, T., Masui, K., Kawakami, A., Kawaguchi, Y., Sato, S., Kuwana, M., Okano, Y., Nishina, N., Tamura, M., Kirino, Y., Ikeda, K., Kikuchi, J., Kubo, M., Tanino, Y., Kaieda, S., ... Kawahara, Y. (2020). Clinical characteristics of cancer-associated myositis complicated by interstitial lung disease: A large-scale multicentre cohort study. Rheumatology (United Kingdom), 59(1), 112-119. https://doi.org/10.1093/rheumatology/kez238