Progression prediction in idiopathic inflammatory myopathy-associated interstitial lung disease: a combination of initial high attenuation areas and anti-melanoma differentiation-associated gene 5-positive.

Abstract

To analyse quantitative lung densitometry and clinical baseline data of individuals with idiopathic inflammatory myopathy (IIM) and identify risk factors capable of predicting the progression of interstitial lung disease (ILD). We utilised quantitative lung densitometry and clinical baseline data as explanatory variables. Univariate and multivariate Cox regression analyses were employed to pinpoint effective risk factors for predicting ILD progression in IIM patients. The findings from the Cox univariate regression analysis indicate that elevated carcinoembryonic antigen levels (HR=1.036, 95% CI 1.004-1.069) are connected to an elevated risk of ILD progression in patients with IIM (P=0.027), while PO2 (HR=0.980, 95% CI 0.962-0.997) , forced vital capacity (HR=0.551, 95% CI 0.320-0.946) are protective factors for ILD progression in patients with IIM (p=0.025, p=0.031, respectively), anti-EJ positivity (HR=0.399, 95% CI 0.175-0.912) and anti-Ro52 positivity (HR=0.437, 95% CI 0.199-0.960) are risk factors for ILD progression in patients with IIM (p=0.029, p=0.039, respectively). Furthermore, the results of Cox multivariate regression analysis reveal that high attenuation areas (HAA) (>465.745 cm3) (HR=5.007, 95% CI 1.773-14.144) and anti-melanoma differentiation-associated gene 5 (Anti-MDA5) positivity (HR=0.127, 95% CI 0.041-0.396) are autonomous prognostic risk factors for ILD progression in individuals with IIM (p=0.002, p<0.001, respectively). Among IIM patients, those who are anti-MDA5-positive, and exhibit HAA (>465.745cm3) are more likely to experience ILD progression.