Functional outcome and prognostic factors in anti-Jo1 patients with antisynthetase syndromeReportar como inadecuado




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* Corresponding author 1 Service de Médecine interne Rouen 2 Physiopathologie et biothérapies des maladies inflammatoires et autoimmunes 3 Service de médecine interne Lille 4 Service de Médecine interne 5 Médecine interne 6 Service de Rhumatologie Rouen 7 Service de Biostatistique 8 Laboratoire d-Immunologie 9 Service de Pneumologie

Abstract : IntroductionThe aims of this present study were firstly to assess the outcome, including functional course, in anti-Jo1 positive patients with antisynthetase syndrome ASS, and secondly to determine predictive parameters of poor outcome in these patients.MethodsThe medical records of 86 consecutive anti-Jo1 patients with ASS were reviewed in 4 academic centers.Results13 patients 15.1% achieved remission of ASS, whereas 55 63.9% improved and 18 20.9% deteriorated in their clinical status. Both steroid and cytotoxic drugs could be discontinued in only 4.7% of patients. ASS was associated with decreased quality of life at long-term follow-up: only 69.2% of patients considered to be in remission experienced a return to previous normal activities; and 24.7% of other patients with non-remitting ASS still had a marked reduction of activities as shown by the disability scale of the Health Assessment Questionnaire. Decreased quality of life was further due to calcinosis cutis 8.1% and adverse effects of steroid therapy 36%. Factors associated with ASS deterioration were older age, pulmonary and esophageal involvement, calcinosis cutis and cancer. Higher anti-Jo1 levels were further associated with disease severity in ASS patients.ConclusionsThe present study shows high morbidity related to ASS. Furthermore, we suggest that patients with predictive factors of ASS deterioration may require more aggressive therapy. Our findings also suggest that in anti-Jo1 patients with severe esophageal manifestations, combined high dose steroids and intravenous immunoglobulins might be proposed as the first line therapy. Finally, as cancer occurred in 14% of anti-Jo1 patients, our findings underscore that the search for cancer should be performed in these patients.





Autor: Isabelle Marie - Pierre-Yves Hatron - Patrick Cherin - Eric Hachulla - Elisabeth Diot - Olivier Vittecoq - Jean-François Menard

Fuente: https://hal.archives-ouvertes.fr/



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