A Path to Prediction of Outcomes in Juvenile Idiopathic Inflammatory Myopathy

Abstract

Humans have an innate desire to observe and subsequently dissect an event into component pieces in an effort to better characterize the event. We then examine these pieces individually and in combinations using this information to determine the outcome of future similar events and the likelihood of their recurrence. Practically, this attempt to foretell an occurrence and predict its outcomes is evident in multiple disciplines ranging from meteorology to sociologic studies. In this manuscript we share the historical and present-day tools to predict course and outcome in juvenile idiopathic inflammatory myopathy including clinical features, testing, and biomarkers. Further we discuss considerations for building more complex predictive models of outcome especially in diseases such as juvenile idiopathic inflammatory myopathy where patients numbers are low. Many of the barriers to developing risk prediction models for juvenile idiopathic inflammatory myopathy outcomes have improved with many remaining challenges being addressed.

Incorporating circulating cytokines into the idiopathic inflammatory myopathy subclassification toolkit

“…It is highly unlikely that a single circulating biomarker can be identified which is capable of diagnosing and/or subtyping IIM, yet a clever combination of biomarkers could potentially do the trick. As has been stated by Reed et al in the context of juvenile IIM, individual biomarkers may provide useful information yet a concerted effort may be necessary to augment their use for clinical practice ( 36 ). Combining autoantibody profiling with quantification of CK, GDF-15 and CXCL10 in patient blood samples is proposed as a diagnostic strategy for IIM which would be able to reduce the need for skeletal muscle tissue evaluation.…”