目的:这项回顾性研究的目的是在墨西哥动态队列中首次对ACR/EULAR炎性肌病(IIM)分类标准进行外部验证,对患者进行临床和实验室评估。作为次要目标,我们介绍了患者的临床特征,并纳入了抗Jo1抗体以外的抗体,以评估其对我们人群的影响.
方法:本研究包括70例IIM患者和70例IIM鉴别诊断患者,根据分类标准的绝对得分。我们在没有活检的情况下获得了敏感性和特异性,作为探索性分析,我们从肌炎扩展组中添加了其他抗体。我们分析了三个模型的曲线下面积(AUC):无抗体评分,抗Jo1和任何抗体。
结果:ACR/EULAR标准显示特异性增加,并且至少与原始队列的敏感性相似(敏感性为85%,特异性为92%),队列点>55%。当我们把病人分类为明确的,可能,可能,没有IIM类别,通过添加扩展的肌病面板,最初分类为“无IIM”的10名患者中有6名将其分类更改为“可能的IIM”,4名更改为“确定的IIM”;在分类为“可能的IIM”的16名患者中,\"15将其分类更改为\"DefiniteIIM。\"
结论:考虑到本研究的局限性,我们的结论是,2017年EULAR/ACR的IIM分类标准对于墨西哥人群中IIM患者的分类是敏感和特异的.此外,添加除抗Jo1以外的抗体可能会改善某些群体的表现。
OBJECTIVE: This retrospective study aimed to perform the first external validation of the ACR/EULAR classification criteria for inflammatory myopathy (IIM) in a Mexican dynamic cohort where the patients were evaluated with clinical and laboratory values. As secondary objectives, we presented the clinical characteristics of the patients and included antibodies other than anti Jo1 to evaluate their impact on our population.
METHODS: This study included 70 patients with IIM and 70 patients with differential diagnoses of IIM, according to the absolute score of the classification criteria. We obtained sensitivity and specificity in the modality without biopsy, and as an exploratory analysis, we added other antibodies from the myositis extended panel. We analyzed the area under the curve (AUC) of three models: score without antibodies, with anti Jo1 and with any antibody.
RESULTS: The ACR/EULAR criteria showed increased specificity and at least similar sensitivity to that of the original cohort (85% sensitivity and 92% specificity), with a cohort point of >55%. When we classified patients into definite, probable, possible, and no IIM categories, by adding the extended myopathy panel, 6 of the 10 patients initially classified as \"no IIM\" changed their classification to \"Probable IIM\" and 4 to \"Definite IIM\"; of the 16 patients classified as \"probable IIM,\" 15 changed their classification to \"Definite IIM.\"
CONCLUSIONS: Considering the limitations of this study, we concluded that the 2017 EULAR/ACR criteria for IIM classification are sensitive and specific for classifying patients with IIM in the Mexican population. Additionally, the addition of antibodies other than anti-Jo1 may improve performance in certain populations.