TY - JOUR
T1 - Clinical characteristics of cancer-associated myositis complicated by interstitial lung disease
T2 - A large-scale multicentre cohort study
AU - Kaneko, Yuko
AU - Nunokawa, Takahiro
AU - Taniguchi, Yoshinori
AU - Yamaguchi, Yukie
AU - Gono, Takahisa
AU - Masui, Kenichi
AU - Kawakami, Atsushi
AU - Kawaguchi, Yasushi
AU - Sato, Shinji
AU - Kuwana, Masataka
AU - Okano, Yutaka
AU - Nishina, Naoshi
AU - Tamura, Maasa
AU - Kirino, Yohei
AU - Ikeda, Kei
AU - Kikuchi, Jun
AU - Kubo, Makoto
AU - Tanino, Yoshinori
AU - Kaieda, Shinjiro
AU - Naniwa, Taio
AU - Watanabe, Masaki
AU - Harada, Tatsuhiko
AU - Ukichi, Taro
AU - Kazuyori, Taisuke
AU - Kameda, Hideto
AU - Kaburaki, Makoto
AU - Matsuzawa, Yasuo
AU - Yoshida, Shunji
AU - Yoshioka, Yasuko
AU - Hirai, Takuya
AU - Asakawa, Katsuaki
AU - Wada, Yoko
AU - Ishii, Koji
AU - Fujiwara, Sakuhei
AU - Saraya, Takeshi
AU - Morimoto, Kozo
AU - Hara, Tetsu
AU - Suzuki, Hiroki
AU - Shibuya, Hideki
AU - Muro, Yoshinao
AU - Aki, Ryoichi
AU - Shibayama, Takuo
AU - Ohshima, Shiro
AU - Yasuda, Yuko
AU - Terada, Masaki
AU - Kawahara, Yoshie
N1 - Funding Information:
Disclosure statement: YuK received Speaker’s bureau from Astellas. TN, YT, YY, TG, KM, and AK declare no conflict of interest. SS holds a patent for the anti-MDA5 antibody measurement kit. MK holds a patent for the anti-MDA5 antibody measurement kit, received research grants from Astellas, and speakers’ bureau from Astellas, Japan Blood Products Organization, and MBL.
Funding Information:
Funding: This work was supported in part by a research grant from Astellas. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - 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.
AB - 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.
KW - cancer-associated
KW - interstitial lung diseases
KW - myositis
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U2 - 10.1093/rheumatology/kez238
DO - 10.1093/rheumatology/kez238
M3 - Article
C2 - 31382295
AN - SCOPUS:85076448504
SN - 1462-0324
VL - 59
SP - 112
EP - 119
JO - Rheumatology and Rehabilitation
JF - Rheumatology and Rehabilitation
IS - 1
ER -
