%0 Journal Article %T Clinical risk factors in patients with interstitial lung disease associated with anti-MDA5 autoantibodies. %A Ramos-Martinez E %A Rodríguez-Vega EA %A Rivera-Matias PA %A Falfán-Valencia R %A Pérez-Rubio G %A Mejia M %A González-Pérez MI %A Buendia-Roldán I %A Mateos-Toledo HN %A Serrano JR %J Med Clin (Barc) %V 161 %N 12 %D 2023 12 22 %M 37567825 %F 3.2 %R 10.1016/j.medcli.2023.07.013 %X The anti-MDA5-associated autoimmune disease represents a poorly understood entity. The study's objectives were to describe a cohort of interstitial lung disease (ILD) patients who were positive for anti-MDA5 autoantibody and identify clinical risk factors associated with survival.
This single-center cohort study included ILD patients positive for anti-MDA5 autoantibody. Baseline clinical features were registered, and survival analysis was performed to identify risk factors associated with worse survival.
Fifty-three ILD-MDA5 positive patients were included; twelve died during follow-up due to rapidly progressive interstitial lung disease (RP-ILD). Dermatological signs of anti-MDA5 (Gottron papules, Gottron sign, palmar papules, V-neck sign, facial dermatomyositis rashes, and skin ulcers) were strongly associated with death secondary to RP-ILD (HR: 3.7, 95% CI: 1.02-13.35). Patients with dermatological signs were younger, had higher anti-MDA5 autoantibodies titers, more frequent inflammatory patterns in HRCT evaluation, and less fibrosis extent in HRCT.
Dermatological manifestation in ILD patients to anti-MDA5 autoantibodies are associated with RP-ILD and short-term fatal outcomes. Dermatological signs may identify a subgroup of ILD-positive to anti-MDA5 patients with a high risk of RP-ILD.