Screening for Myositis Antibodies in Idiopathic Interstitial Lung Disease
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International guidelines recommend screening for connective tissue disease (CTD) with autoantibodies when evaluating patients with idiopathic interstitial lung disease (ILD). Idiopathic inflammatory myositis comprises of a subgroup of CTD diagnosed with myositis antibodies (MA), often presenting with ILD. Our aim was to evaluate the utility of MA screening in patients with idiopathic ILD.
A retrospective analysis was conducted on patients referred with idiopathic ILD to a tertiary centre ILD clinic who were screened for MA. Patients with known or suspected CTD were excluded. Descriptive statistics, univariate analysis and multivariable logistic regression were used to detect associations between MA and patient characteristics.
Of 360 patients, 165 met inclusion criteria and 44 (26.7%) were identified to have MA. Fourteen patients (8.5%) had a change in diagnosis as a result of MA screening. Multivariable logistic regression identified the presence of MA to be associated with current smoking [OR 6.87 (1.65–28.64), p = 0.008] and a diffusing capacity of < 70% predicted [OR 2.55 (1.09–5.97), p = 0.03]. In patients with a change in diagnosis due to MA screening, 3 (1.8%) underwent a surgical lung biopsy and 2 (1.2%) were previously treated with antifibrotic therapy.
Screening for MA in patients with idiopathic ILD can contribute to a change in patient diagnosis, and may prevent invasive testing and unproven use of antifibrotic therapy. These results support the addition of MA to CTD screening panels during the initial evaluation of idiopathic ILD.
KeywordsConnective tissue disease Idiopathic inflammatory myositis Interstitial lung disease
Aminoacyl-tRNA synthetase antibodies
Anti-cyclic citrullinated peptide
Connective tissue disease
Diffusing capacity of the lung for carbon monoxide
Forced vital capacity
Idiopathic inflammatory myositis
Interstitial lung disease
Idiopathic pulmonary fibrosis
Non-specific interstitial pneumonia
Pulmonary function testing
Surgical lung biopsy
Anti-signal recognition particle
Usual interstitial pneumonia
LF is the guarantor of this research, and takes responsibility for the integrity of this work. All authors contributed to manuscript revisions, and provided final approval of the version for publication. LF, SS and SM contributed to the study concept and design, statistical analysis, drafting of initial manuscript and study supervision. Other contributions: none.
Funding for this project was obtained from the Canadian Pulmonary Fibrosis Foundation.
Compliance with Ethical Standards
Conflict of interest
SS has participated in speaking engagements and advisory boards for Hoffman-LaRoche Canada, Boehringer-Ingelheim Canada and AstraZeneca Canada. He has participated in clinical trials research for Hoffman-LeRoche Canada, Boehringer-Ingelheim Canada, Prometic Pharmaceuticals, Gilead Pharmaceuticals and Sanofi-Aventis Canada. All others have no conflicts of interest to declare.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
For this type of study, formal consent is not required.
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