TY - JOUR
T1 - Association of Myositis Autoantibodies, Clinical Features, and Environmental Exposures at Illness Onset with Disease Course in Juvenile Myositis
AU - Habers, G. Esther A.
AU - Huber, Adam M.
AU - Mamyrova, Gulnara
AU - Targoff, Ira N.
AU - O’Hanlon, Terrance P.
AU - Adams, Sharon
AU - Pandey, Janardan P.
AU - Boonacker, Chantal
AU - Van Brussel, Marco
AU - Miller, Frederick W.
AU - Van Royen-Kerkhof, Annet
AU - Rider, Lisa G.
AU - Abramson, Leslie S.
AU - Albert, Daniel A.
AU - April Bingham, C.
AU - Bohnsack, John F.
AU - Bowyer, Suzanne
AU - Burnham, Jon M.
AU - Carrasco, Ruy
AU - Cartwright, Victoria W.
AU - Cawkwell, Gail D.
AU - Cron, Randy Q.
AU - Curiel, Rodolfo
AU - Eichenfield, Andrew H.
AU - Finkel, Terri H.
AU - Fuhlbrigge, Robert C.
AU - Gabriel, Christos A.
AU - George, Stephen W.
AU - Gewanter, Harry L.
AU - Goldbach-Mansky, Raphaela
AU - Goldmuntz, Ellen A.
AU - Goldsmith, Donald P.
AU - Haftel, Hillary M.
AU - Hawkins-Holt, Melissa
AU - Henrickson, Michael
AU - Higgins, Gloria C.
AU - Roger Hollister, J.
AU - Imundo, Lisa
AU - Jacobs, Jerry C.
AU - Jansen, Anna
AU - Jarvis, James
AU - Jones, Olcay Y.
AU - Jung, Lawrence K.
AU - Katona, Ildy M.
AU - Kimura, Yukiko
AU - Patrick Knibbe, W.
AU - Lang, Bianca A.
AU - Lindsley, Carol B.
AU - Mitchell, Stephen R.
AU - Ray, Linda I.
AU - for the Childhood Myositis Heterogeneity Study Group
N1 - Publisher Copyright:
© 2016, American College of Rheumatology.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - 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.
AB - 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.
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U2 - 10.1002/art.39466
DO - 10.1002/art.39466
M3 - Article
C2 - 26474155
AN - SCOPUS:84963803930
SN - 2326-5191
VL - 68
SP - 761
EP - 768
JO - Arthritis and Rheumatology
JF - Arthritis and Rheumatology
IS - 3
ER -