A MATRIX PREDICTION MODEL FOR THE SIXMONTH MORTALITY RISK IN PATIENTS WITH ANTI-MELANOMA DIFFERENTIATION-ASSOCIATED PROTEIN-5 POSITIVE DERMATOMYOSITIS
Authors: A. J. Tang et al.
Anti-MDA5 autoantibodies delineate a subgroup of dermatomyositis patients with a high risk of life-threatening lung complications. In order to identify independent risk factors for predicting 6-month mortality of anti-MDA5-positive 82 DM patients were enrolled (mean age of onset 50 years, 63% female), with 40 (49%). Gottron papules (OR: 5.1), arthritis (OR: 5.2), and interstitial lung disease (OR: 7.0) were independently associated with anti-MDA5-positivity. Anti-MDA5-positive patients had significant higher 6-month all-cause mortality (30% vs. 0%). Among anti-MDA5-positive DM patients, compared to the survivors, non-survivors had significantly advanced age of onset (59 years vs. 46 years), higher rates of fever (75% vs. 18%), positive carcinoma embryonic antigen (CEA, 75% vs. 14%), higher level of ferritin (median 2858 ug/L vs. 619 ug/L).
Multivariate COX regression showed ferritin ≥ 1250 µg/L (HR: 10.4), fever (HR: 11.2), and positive CEA (HR: 5.2) as independent risk factors of 6-month mortality.
Baseline characteristics of fever, positive CEA, and ferritin ≥ 1250 µg/L are risk factors for 6-month all-cause mortality in anti-MDA5-positive DM patients. The association with CEA elevation deserves replication in other cohorts and mechanistic studies.