British Society for Rheumatology guideline on management of paediatric, adolescent and adult patients with idiopathic inflammatory myopathy

Oldroyd, Alexander; Lilleker, James B; Amin, Tania; Aragon, Octavio; Bechman, Katie; Cuthbert, Verna; Galloway, James; Gordon, Patrick; Gregory, William J; Gunawardena, Harsha; Hanna, Michael G.; Isenberg, David; Jackman, John; Kiely, Patrick; Livermore, Polly; Machado, Pedro; Maillard, Sue; McHugh, Neil; Murphy, Ruth; Pilkington, Clarissa; Prabu, Athiveeraramapandian; Rushe, Phoebe; Spinty, Stefan; Swan, Joanne; Tahir, Hasan; Tansley, Sarah; Truepenny, Paul; Truepenny, Yvonne; Warrier, Kishore; Yates, Mark; Papadopoulou, Charalampia; Martin, Neil; McCann, Liza; Chinoy, Hector

doi:10.1093/rheumatology/keac115

Cited by 63 publications

(61 citation statements)

References 44 publications

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“…ELISA is a singleplex immunoassay, and testing for a single antibody may not be cost-effective when assessing a heterogeneous rare disease with multiple MSA’s. Multiplex immunoassays such as line blots offer increased efficiency in testing for different MSAs, but accuracy for detecting anti-TIF1γ and rarer anti-synthetase autoantibodies is reduced ( 3 , 21 ). Patients being evaluated for MSA in the real world may have other autoantibodies, paraproteins or hypergammaglobulinemia that could interfere with the diagnostic performance of ELISAs ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…A unique benefit of ELISA immunoassay is that it can provide the clinician with a quantitative result with antibody levels that may reflect disease activity. Whilst the recently published British Society of Rheumatology guidelines for managing inflammatory myositis do not recommend measuring autoantibody levels to monitor disease activity based on insufficient evidence ( 23 ), this is an exciting area for future research. In the future, autoantibody titre may be used routinely in clinical practice for disease monitoring ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

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The use of ELISA is comparable to immunoprecipitation in the detection of selected myositis-specific autoantibodies in a European population

Loganathan

McMorrow

et al. 2022

Front. Immunol.

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BackgroundThe reliable detection of myositis-specific autoantibodies (MSA) provides valuable clinical information regarding prognosis, clinical progression and diagnostic confirmation.ObjectivesTo evaluate the reliability of a commercial ELISA immunoassay in detecting myositis-specific autoantibodies in comparison to immunoprecipitation as the reference standard.MethodsSerum samples were chosen from a biobank of more than 3000 samples. Samples with a confirmed MSA on Immunoprecipitation (n=116) were evaluated in duplicate by ELISA to detect Mi2, MDA5, Jo1, EJ, KS, PL-7 and PL-12 (Medical & Biological Laboratories Co. Ltd, Nagoya, Aichi, Japan). Healthy control samples (n=246) confirmed autoantibody negative by immunoprecipitation were similarly assessed.ResultsThere was a very good agreement between ELISA and immunoprecipitation for serum samples containing anti-Mi2, MDA5, Jo1, EJ, KS and PL-7 and PL-12 auto-antibodies. Cohen’s κ values ranged from 0.86-1 for the measured autoantibodies on ELISA.ConclusionELISA was an accurate method for detecting anti-synthetase, anti-Mi2 and anti-MDA5 autoantibodies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The use of ELISA is comparable to immunoprecipitation in the detection of selected myositis-specific autoantibodies in a European population

Loganathan

McMorrow

et al. 2022

Front. Immunol.

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“…• After an adequate cancer-risk stratification, performing a PET/CT scan at myositis onset seems to be an efficient approach to rule out CAM, with a high negative predictive value (108). (114). GCs remain the milestone for the treatment of IIM.…”

Section: Take-home Messagesmentioning

confidence: 99%

Idiopathic inflammatory myopathies: one year in review 2022

Cardelli

Zanframundo

Cometi

et al. 2023

Clinical and Experimental Rheumatology

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Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of disorders in which chronic inflammation of the skeletal muscle, leading to muscle weakness, is a common feature. Different phenotypes have been identified within the IIM spectrum based on extra-muscular manifestations, immunology, muscle histology, responsiveness to therapy, and prognosis. The pathogenesis, classification, treatment, and prognosis of the different IIM subtypes are subject to active discussion and research. This review highlights the most relevant literature published on this topic over the last year.

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“…Muscle enzymes may be normal, and while they can be useful markers of disease activity, they do not necessarily correlate with myositis activity, especially in more chronic diseases. British Society of Rheumatology guidelines recommend testing for myositis antibodies in patients with suspected inflammatory myopathy ( 48 ), and in the correct clinical context, these may be diagnostic.…”

Section: Myopathymentioning

confidence: 99%

“…With the growing availability of commercial serological assays for identifying antisynthetase antibodies, there is less need for muscle biopsy for the diagnosis of ASyS. Muscle histology still has an important role in cases where the clinical picture of IIM is incomplete, for example, if there are no obvious CTD features or where a circulating myositis-specific antibody cannot be identified ( 48 ).…”

Section: Myopathymentioning

confidence: 99%

A multidisciplinary approach to the diagnosis of antisynthetase syndrome

et al. 2022

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Antisynthetase syndrome is a subtype of idiopathic inflammatory myopathy, strongly associated with the presence of interstitial lung disease. Diagnosis is made by identifying myositis-specific antibodies directed against aminoacyl tRNA synthetase, and relevant clinical and radiologic features. Given the multisystem nature of the disease, diagnosis requires the careful synthesis of subtle clinical and radiological features with the interpretation of specialized autoimmune serological testing. This is provided in a multidisciplinary environment with input from rheumatologists, respiratory physicians, and radiologists. Differentiation from other idiopathic interstitial lung diseases is key; treatment and prognosis differ between patients with antisynthetase syndrome and idiopathic interstitial lung disease. In this review article, we look at the role of the multidisciplinary team and its individual members in the initial diagnosis of the antisynthetase syndrome, including the role of physicians, radiologists, and the wider team.

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British Society for Rheumatology guideline on management of paediatric, adolescent and adult patients with idiopathic inflammatory myopathy

Cited by 63 publications

References 44 publications

The use of ELISA is comparable to immunoprecipitation in the detection of selected myositis-specific autoantibodies in a European population

The use of ELISA is comparable to immunoprecipitation in the detection of selected myositis-specific autoantibodies in a European population

Idiopathic inflammatory myopathies: one year in review 2022

A multidisciplinary approach to the diagnosis of antisynthetase syndrome

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