Association of Myositis Autoantibodies, Clinical Features, and Environmental Exposures at Illness Onset with Disease Course in Juvenile Myositis

G. Esther A. Habers, Adam M. Huber, Gulnara Mamyrova, Ira N. Targoff, Terrance P. O’Hanlon, Sharon Adams, Janardan P. Pandey, Chantal Boonacker, Marco Van Brussel, Frederick W. Miller, Annet Van Royen-Kerkhof, Lisa G. Rider, Leslie S. Abramson, Daniel A. Albert, C. April Bingham, John F. Bohnsack, Suzanne Bowyer, Jon M. Burnham, Ruy Carrasco, Victoria W. CartwrightGail D. Cawkwell, Randy Q. Cron, Rodolfo Curiel, Andrew H. Eichenfield, Terri H. Finkel, Robert C. Fuhlbrigge, Christos A. Gabriel, Stephen W. George, Harry L. Gewanter, Raphaela Goldbach-Mansky, Ellen A. Goldmuntz, Donald P. Goldsmith, Hillary M. Haftel, Melissa Hawkins-Holt, Michael Henrickson, Gloria C. Higgins, J. Roger Hollister, Lisa Imundo, Jerry C. Jacobs, Anna Jansen, James Jarvis, Olcay Y. Jones, Lawrence K. Jung, Ildy M. Katona, Yukiko Kimura, W. Patrick Knibbe, Bianca A. Lang, Carol B. Lindsley, Stephen R. Mitchell, Linda I. Ray, for the Childhood Myositis Heterogeneity Study Group

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Objective To identify early factors associated with disease course in patients with juvenile idiopathic inflammatory myopathies (IIMs). Methods Univariable and multivariable multinomial logistic regression analyses were performed in a large juvenile IIM registry (n = 365) and included demographic characteristics, early clinical features, serum muscle enzyme levels, myositis autoantibodies, environmental exposures, and immunogenetic polymorphisms. Results Multivariable associations with chronic or polycyclic courses compared to a monocyclic course included myositis-specific autoantibodies (multinomial odds ratio [OR] 4.2 and 2.8, respectively), myositis-associated autoantibodies (multinomial OR 4.8 and 3.5), and a documented infection within 6 months of illness onset (multinomial OR 2.5 and 4.7). A higher overall clinical symptom score at diagnosis was associated with chronic or monocyclic courses compared to a polycyclic course. Furthermore, severe illness onset was associated with a chronic course compared to monocyclic or polycyclic courses (multinomial OR 2.1 and 2.6, respectively), while anti-p155/140 autoantibodies were associated with chronic or polycyclic courses compared to a monocyclic course (multinomial OR 3.9 and 2.3, respectively). Additional univariable associations of a chronic course compared to a monocyclic course included photosensitivity, V-sign or shawl sign rashes, and cuticular overgrowth (OR 2.2-3.2). The mean ultraviolet index and highest ultraviolet index in the month before diagnosis were associated with a chronic course compared to a polycyclic course in boys (OR 1.5 and 1.3), while residing in the Northwest was less frequently associated with a chronic course (OR 0.2). Conclusion Our findings indicate that myositis autoantibodies, in particular anti-p155/140, and a number of early clinical features and environmental exposures are associated with a chronic course in patients with juvenile IIM. These findings suggest that early factors, which are associated with poorer outcomes in juvenile IIM, can be identified.

Original languageEnglish (US)
Pages (from-to)761-768
Number of pages8
JournalArthritis and Rheumatology
Volume68
Issue number3
DOIs
StatePublished - Mar 1 2016

    Fingerprint

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology

Cite this

Habers, G. E. A., Huber, A. M., Mamyrova, G., Targoff, I. N., O’Hanlon, T. P., Adams, S., Pandey, J. P., Boonacker, C., Van Brussel, M., Miller, F. W., Van Royen-Kerkhof, A., Rider, L. G., Abramson, L. S., Albert, D. A., April Bingham, C., Bohnsack, J. F., Bowyer, S., Burnham, J. M., Carrasco, R., ... for the Childhood Myositis Heterogeneity Study Group (2016). Association of Myositis Autoantibodies, Clinical Features, and Environmental Exposures at Illness Onset with Disease Course in Juvenile Myositis. Arthritis and Rheumatology, 68(3), 761-768. https://doi.org/10.1002/art.39466