Initial predictors of poor survival in myositisassociated interstitial lung disease

A multicentre cohort of 497 patients

A Multicentre Retrospective Cohort of Japanese Patients with Myositis-associated ILD Investigators

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective. To identify initial predictors of poor survival in patients with PM/DM-associated interstitial lung disease (ILD). Methods. We established a multicentre retrospective cohort of incident cases of PM/DM-associated ILD from 44 institutions across Japan (Multicentre Retrospective Cohort of Japanese Patients with Myositisassociated ILD, JAMI). Inclusion criteria were an onset age ≥16 years; PM/DM or clinically amyopathic DM according to the published criteria; imaging evidence of ILD; and availability of serum samples for assays of autoantibodies such as anti-melanoma differentiation-associated gene 5 and anti-aminoacyl tRNA synthetase. We collected demographic data and clinical characteristics recorded at the time of diagnosis, as well as follow-up survival data. Predictors of ILD-related mortality were identified by univariate and multivariate analyses. Results. JAMI enrolled a cohort of 497 patients with PM (15%), classic DM (32%) and clinically amyopathic DM (53%). During the observation period (median 20 months), 76 died of respiratory insufficiency directly related to ILD. Univariate analysis revealed several initial parameters associated with ILD mortality, including demographic, clinical, laboratory, imaging and autoantibody variables. We used multivariate analysis with a stepwise selection of parameters to generate an appropriate predictive model, and identified the following independent risk factors for ILD mortality: age at onset ≥60 years [hazard ratio (HR) = 4.3, 95% CI: 2.4, 7.5], CRP ≥1 mg/dl (HR = 2.6, 95% CI: 1.5, 4.8), peripheral capillary oxygen saturation <95% (HR = 2.0, 95% CI: 1.2, 3.4) and anti-melanoma differentiation-associated gene 5 antibody (HR = 7.5, 95% CI: 2.8, 20.2). Conclusion. We established a large cohort of incident cases of PM/DM-associated ILD, and successfully identified independent predictors of short-term ILD mortality.

Original languageEnglish
Pages (from-to)1212-1221
Number of pages10
JournalRheumatology (United Kingdom)
Volume57
Issue number7
DOIs
Publication statusPublished - 2018 Jul 1

Fingerprint

Interstitial Lung Diseases
Survival
Mortality
Age of Onset
Autoantibodies
Melanoma
Multivariate Analysis
Demography
Amino Acyl-tRNA Synthetases
Respiratory Insufficiency
Genes
Japan
Observation
Oxygen
Antibodies

Keywords

  • Autoantigens and autoantibodies
  • Biomarkers
  • Myositis and muscle disease
  • Outcome measures
  • Respiratory

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Cite this

A Multicentre Retrospective Cohort of Japanese Patients with Myositis-associated ILD Investigators (2018). Initial predictors of poor survival in myositisassociated interstitial lung disease: A multicentre cohort of 497 patients. Rheumatology (United Kingdom), 57(7), 1212-1221. https://doi.org/10.1093/rheumatology/key060

Initial predictors of poor survival in myositisassociated interstitial lung disease : A multicentre cohort of 497 patients. / A Multicentre Retrospective Cohort of Japanese Patients with Myositis-associated ILD Investigators.

In: Rheumatology (United Kingdom), Vol. 57, No. 7, 01.07.2018, p. 1212-1221.

Research output: Contribution to journalArticle

A Multicentre Retrospective Cohort of Japanese Patients with Myositis-associated ILD Investigators 2018, 'Initial predictors of poor survival in myositisassociated interstitial lung disease: A multicentre cohort of 497 patients', Rheumatology (United Kingdom), vol. 57, no. 7, pp. 1212-1221. https://doi.org/10.1093/rheumatology/key060
A Multicentre Retrospective Cohort of Japanese Patients with Myositis-associated ILD Investigators. Initial predictors of poor survival in myositisassociated interstitial lung disease: A multicentre cohort of 497 patients. Rheumatology (United Kingdom). 2018 Jul 1;57(7):1212-1221. https://doi.org/10.1093/rheumatology/key060
A Multicentre Retrospective Cohort of Japanese Patients with Myositis-associated ILD Investigators. / Initial predictors of poor survival in myositisassociated interstitial lung disease : A multicentre cohort of 497 patients. In: Rheumatology (United Kingdom). 2018 ; Vol. 57, No. 7. pp. 1212-1221.
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abstract = "Objective. To identify initial predictors of poor survival in patients with PM/DM-associated interstitial lung disease (ILD). Methods. We established a multicentre retrospective cohort of incident cases of PM/DM-associated ILD from 44 institutions across Japan (Multicentre Retrospective Cohort of Japanese Patients with Myositisassociated ILD, JAMI). Inclusion criteria were an onset age ≥16 years; PM/DM or clinically amyopathic DM according to the published criteria; imaging evidence of ILD; and availability of serum samples for assays of autoantibodies such as anti-melanoma differentiation-associated gene 5 and anti-aminoacyl tRNA synthetase. We collected demographic data and clinical characteristics recorded at the time of diagnosis, as well as follow-up survival data. Predictors of ILD-related mortality were identified by univariate and multivariate analyses. Results. JAMI enrolled a cohort of 497 patients with PM (15{\%}), classic DM (32{\%}) and clinically amyopathic DM (53{\%}). During the observation period (median 20 months), 76 died of respiratory insufficiency directly related to ILD. Univariate analysis revealed several initial parameters associated with ILD mortality, including demographic, clinical, laboratory, imaging and autoantibody variables. We used multivariate analysis with a stepwise selection of parameters to generate an appropriate predictive model, and identified the following independent risk factors for ILD mortality: age at onset ≥60 years [hazard ratio (HR) = 4.3, 95{\%} CI: 2.4, 7.5], CRP ≥1 mg/dl (HR = 2.6, 95{\%} CI: 1.5, 4.8), peripheral capillary oxygen saturation <95{\%} (HR = 2.0, 95{\%} CI: 1.2, 3.4) and anti-melanoma differentiation-associated gene 5 antibody (HR = 7.5, 95{\%} CI: 2.8, 20.2). Conclusion. We established a large cohort of incident cases of PM/DM-associated ILD, and successfully identified independent predictors of short-term ILD mortality.",
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TY - JOUR

T1 - Initial predictors of poor survival in myositisassociated interstitial lung disease

T2 - A multicentre cohort of 497 patients

AU - A Multicentre Retrospective Cohort of Japanese Patients with Myositis-associated ILD Investigators

AU - Sato, Shinji

AU - Masui, Kenichi

AU - Nishina, Naoshi

AU - Kawaguchi, Yasushi

AU - Kawakami, Atsushi

AU - Tamura, Maasa

AU - Ikeda, Kei

AU - Nunokawa, Takahiro

AU - Tanino, Yoshinori

AU - Asakawa, Katsuaki

AU - Kaneko, Yuko

AU - Gono, Takahisa

AU - Ukichi, Taro

AU - Kaieda, Shinjiro

AU - Naniwa, Taio

AU - Kuwana, Masataka

AU - Okano, Yutaka

AU - Yamaguchi, Yukie

AU - Taniguchi, Yoshinori

AU - Kikuchi, Jun

AU - Kubo, Makoto

AU - Watanabe, Masaki

AU - Harada, Tatsuhiko

AU - Kazuyori, Taisuke

AU - Kameda, Hideto

AU - Kaburaki, Makoto

AU - Matsuzawa, Yasuo

AU - Yoshida, Shunji

AU - Yoshioka, Yasuko

AU - Hirai, Takuya

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

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Objective. To identify initial predictors of poor survival in patients with PM/DM-associated interstitial lung disease (ILD). Methods. We established a multicentre retrospective cohort of incident cases of PM/DM-associated ILD from 44 institutions across Japan (Multicentre Retrospective Cohort of Japanese Patients with Myositisassociated ILD, JAMI). Inclusion criteria were an onset age ≥16 years; PM/DM or clinically amyopathic DM according to the published criteria; imaging evidence of ILD; and availability of serum samples for assays of autoantibodies such as anti-melanoma differentiation-associated gene 5 and anti-aminoacyl tRNA synthetase. We collected demographic data and clinical characteristics recorded at the time of diagnosis, as well as follow-up survival data. Predictors of ILD-related mortality were identified by univariate and multivariate analyses. Results. JAMI enrolled a cohort of 497 patients with PM (15%), classic DM (32%) and clinically amyopathic DM (53%). During the observation period (median 20 months), 76 died of respiratory insufficiency directly related to ILD. Univariate analysis revealed several initial parameters associated with ILD mortality, including demographic, clinical, laboratory, imaging and autoantibody variables. We used multivariate analysis with a stepwise selection of parameters to generate an appropriate predictive model, and identified the following independent risk factors for ILD mortality: age at onset ≥60 years [hazard ratio (HR) = 4.3, 95% CI: 2.4, 7.5], CRP ≥1 mg/dl (HR = 2.6, 95% CI: 1.5, 4.8), peripheral capillary oxygen saturation <95% (HR = 2.0, 95% CI: 1.2, 3.4) and anti-melanoma differentiation-associated gene 5 antibody (HR = 7.5, 95% CI: 2.8, 20.2). Conclusion. We established a large cohort of incident cases of PM/DM-associated ILD, and successfully identified independent predictors of short-term ILD mortality.

AB - Objective. To identify initial predictors of poor survival in patients with PM/DM-associated interstitial lung disease (ILD). Methods. We established a multicentre retrospective cohort of incident cases of PM/DM-associated ILD from 44 institutions across Japan (Multicentre Retrospective Cohort of Japanese Patients with Myositisassociated ILD, JAMI). Inclusion criteria were an onset age ≥16 years; PM/DM or clinically amyopathic DM according to the published criteria; imaging evidence of ILD; and availability of serum samples for assays of autoantibodies such as anti-melanoma differentiation-associated gene 5 and anti-aminoacyl tRNA synthetase. We collected demographic data and clinical characteristics recorded at the time of diagnosis, as well as follow-up survival data. Predictors of ILD-related mortality were identified by univariate and multivariate analyses. Results. JAMI enrolled a cohort of 497 patients with PM (15%), classic DM (32%) and clinically amyopathic DM (53%). During the observation period (median 20 months), 76 died of respiratory insufficiency directly related to ILD. Univariate analysis revealed several initial parameters associated with ILD mortality, including demographic, clinical, laboratory, imaging and autoantibody variables. We used multivariate analysis with a stepwise selection of parameters to generate an appropriate predictive model, and identified the following independent risk factors for ILD mortality: age at onset ≥60 years [hazard ratio (HR) = 4.3, 95% CI: 2.4, 7.5], CRP ≥1 mg/dl (HR = 2.6, 95% CI: 1.5, 4.8), peripheral capillary oxygen saturation <95% (HR = 2.0, 95% CI: 1.2, 3.4) and anti-melanoma differentiation-associated gene 5 antibody (HR = 7.5, 95% CI: 2.8, 20.2). Conclusion. We established a large cohort of incident cases of PM/DM-associated ILD, and successfully identified independent predictors of short-term ILD mortality.

KW - Autoantigens and autoantibodies

KW - Biomarkers

KW - Myositis and muscle disease

KW - Outcome measures

KW - Respiratory

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