Long-term follow-up of 124 patients with polymyositis and dermatomyositis: Statistical analysis of prognostic factors

Ishizuka, Mariko; Watanabe, Ryu; Ishii, Tomonori; Machiyama, Tomoaki; Akita, Kanae; Fujita, Yöko; Shirota, Yuko; Fujii, Hiroshi; Harigae, Hideo

doi:10.3109/14397595.2015.1054081

Cited by 34 publications

(19 citation statements)

References 22 publications

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“…Statistical analysis was performed using Graph Pad Prism 5 (San Diego, CA, USA) and EZR software (Kanda 2013), as previously described (Ishizuka et al 2016;Yoshida et al 2016). The Fisher's exact test was used for binary data, and the Mann-Whitney U-test was used for continuous data.…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Acute Exacerbation of Interstitial Lung Disease in Japanese Patients with Systemic Sclerosis

Tomiyama

Watanabe

Ishii

et al. 2016

Tohoku J. Exp. Med.

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Systemic sclerosis (SSc) is a systemic autoimmune disease characterized by extensive fibrosis and autoantibodies. Its clinical manifestations are diverse and include Raynaud's phenomenon, gastrointestinal dysmotility, interstitial lung disease (ILD), pulmonary hypertension, and renal crisis. Among these, ILD is the primary cause of SSc-related death. It has been considered that acute exacerbation of ILD (AE-ILD) is not common in patients with SSc; however, little is known about the prevalence of AE-ILD in Japanese patients with SSc. In this study, we aimed to clarify the prevalence, clinical characteristics, and prognosis of patients with SSc who developed AE-ILD and to identify predictive factors for AE-ILD in our Japanese cohorts. Clinical data of patients who visited our department from 1990 to 2014 and fulfilled the 2013 classification criteria for SSc were retrospectively reviewed. A total of 139 patients were enrolled. The mean age of onset was 49.1 years, and 113 (81.3%) patients were female; 116 (83.5%) had limited cutaneous involvement, and the overall 10-year survival rate was 92.0%. Among 66 (47.5%) patients with ILD, 13 (9.4%) developed AE-ILD. Patients with AE-ILD had a significantly higher incidence of overlap with polymyositis (PM) or dermatomyositis (DM) and lower prevalence of anticentromere antibodies with higher mortality rate compared with those without AE-ILD. Multivariate Cox regression analysis identified that an overlap with PM or DM was the most significant predictive factor for AE-ILD. Our study results suggest that Japanese patients with SSc, particularly patients overlapped with PM or DM, have a high risk of AE-ILD.

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Section: Discussionmentioning

confidence: 99%

High Prevalence of Acute Exacerbation of Interstitial Lung Disease in Japanese Patients with Systemic Sclerosis

Tomiyama

Watanabe

Ishii

et al. 2016

Tohoku J. Exp. Med.

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“…The Fisher's exact test was used for binary data, and the Mann-Whitney U-test was used for continuous data, as previously described (Tomiyama et al 2016). The Kaplan-Meier method was used to estimate the retention rate of ABT, and the log-rank test was used to calculate p values (Ishizuka et al 2016;Yoshida et al 2016). Multivariate logistic regression analysis was used to identify factors that were associated with discontinuation of ABT.…”

Section: Discussionmentioning

confidence: 99%

Better Retention of Abatacept Is Associated with High Rheumatoid Factor: A Five-Year Follow-Up Study of Patients with Rheumatoid Arthritis

Okazaki

Watanabe

Harigae

et al. 2020

Tohoku J. Exp. Med.

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Recently, biological disease-modifying antirheumatic drugs (bDMARDs) have revolutionized the treatment of rheumatoid arthritis (RA) and provided patients with a higher chance of achieving clinical remission. Among them, abatacept (ABT), which selectively inhibits T cell activation through blocking costimulation signal, has been reported efficacious in controlling disease activity. Previous studies have shown that ABT has a high retention rate of up to three years with tolerable adverse events; however, it remains unclear whether this is maintained in the longer term. Here we conducted a retrospective five-year follow-up study to explore prognostic factors concerning better retention. In total, 98 patients who were treated with ABT from May 2011 to July 2019 in Osaki Citizen Hospital were enrolled, including 73 female patients (74.5%). The Kaplan-Meier method was used to estimate the retention rate of ABT. The mean age of ABT initiation was 72.1 years. Concomitant methotrexate was prescribed for 39 patients, and ABT was used as the firstline bDMARD for 65 patients. Rheumatoid factor (RF) was positive in 79 patients. One-, three-, and fiveyear retention rates of ABT were 83.3%, 66.2%, and 62.7%, respectively. Approximately two-thirds of discontinuation resulted from an inadequate response. Multivariate logistic regression analysis revealed that positive RF was associated with better drug retention. Receiver operating characteristics analysis showed that patients with high RF (≥ 45 IU/mL) had better retention rate of ABT. In conclusion, ABT shows high retention rate among patients with positive RF. The present study may provide better insights when selecting bDMARDs.

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“…Hence, reliable biomarkers are needed to guide the treatment [20]. Several studies have shown association between serum ferritin and disease severity in various inflammatory disorders including renal involvement in SLE and interstitial lung disease in dermatomyositis [13,14]. Therefore, some authors suggest use of more intensive treatment in newly diagnosed dermatomyositis patients with high serum ferritin levels [13].…”

Section: Discussionmentioning

confidence: 99%

“…Role of serum ferritin as a marker of disease activity and involvement severity has already been shown in sepsis, graft rejection, dermatomyositis and SLE; however, it has not been previously studied in vasculitides [10][11][12][13][14]. Herein, we aim to investigate association of serum ferritin level with activity and severe manifestations of disease in patients with GPA.…”

Section: Introductionmentioning

confidence: 99%

Serum ferritin as an activity marker for granulamotosis with polyangiitis

et al. 2017

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Background: Serum ferritin correlates well with the activities of systemic lupus erythematosus (SLE) and dermatomyositis, but it has not been previously studied in patients with vasculitis. Methods: Medical records of granulomatosis with polyangiitis (GPA, Wegener's granulomatosis) patients with at least six months of regular follow-up were evaluated. The activity of GPA was assessed with Birmingham Vasculitis Activity Score for Wegener's Granulomatosis (BVAS/WG). Serum ferritin and other acute phase markers were measured at initial presentation. Results: Serum ferritin levels were found to be the highest in GPA patients with alveolar hemorrhage, median (IQR) 1041 (1281) lg/L. Patients with renal disease also had high levels of ferritin and it was correlated with concurrent glomerular filtration rate (r ¼ À0.65, p < .001). Serum ferritin is also correlated well with the BVAS/WG scores (r ¼ 0.79, p < .001). Conclusions: Measurement of serum ferritin might help in assessing disease activity of GPA.

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Long-term follow-up of 124 patients with polymyositis and dermatomyositis: Statistical analysis of prognostic factors

Abstract: Our study indicates that when age of onset and serum ferritin are used in combination, we can predict prognosis of patients with PM/DM.

Cited by 34 publications

References 22 publications

High Prevalence of Acute Exacerbation of Interstitial Lung Disease in Japanese Patients with Systemic Sclerosis

High Prevalence of Acute Exacerbation of Interstitial Lung Disease in Japanese Patients with Systemic Sclerosis

Better Retention of Abatacept Is Associated with High Rheumatoid Factor: A Five-Year Follow-Up Study of Patients with Rheumatoid Arthritis

Serum ferritin as an activity marker for granulamotosis with polyangiitis

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