Brief Report: Association of Myositis Autoantibodies, Clinical Features, and Environmental Exposures at Illness Onset With Disease Course in Juvenile Myositis. Issue 3 (March 2016)

• Record Type: Journal Article
• Authors: Habers, G. Esther A.; Huber, Adam M.; Mamyrova, Gulnara; Targoff, Ira N.; O'Hanlon, Terrance P.; Adams, Sharon; Pandey, Janardan P.; Boonacker, Chantal; van Brussel, Marco; Miller, Frederick W.; van Royen‐Kerkhof, Annet; Rider, Lisa G.
• Other Names: Abramson Leslie S. investigator.; Albert Daniel A. investigator.; Bingham C. April investigator.; Bohnsack John F. investigator.; Bowyer Suzanne investigator.; Burnham Jon M. investigator.; Carrasco Ruy investigator.; Cartwright Victoria W. investigator.; Cawkwell Gail D. investigator.; Cron Randy Q. investigator.; Curiel Rodolfo investigator.; Eichenfield Andrew H. investigator.; Finkel Terri H. investigator.; Fuhlbrigge Robert C. investigator.; Gabriel Christos A. investigator.; George Stephen W. investigator.; Gewanter Harry L. investigator.; Goldbach‐Mansky Raphaela investigator.; Goldmuntz Ellen A. investigator.; Goldsmith Donald P. investigator.; Haftel Hillary M. investigator.; Hawkins‐Holt Melissa investigator.; Henrickson Michael investigator.; Higgins Gloria C. investigator.; Hollister J. Roger investigator.; Imundo Lisa investigator.; Jacobs Jerry C. investigator.; Jansen Anna investigator.; Jarvis James investigator.; Jones Olcay Y. investigator.; Jung Lawrence K. investigator.; Katona Ildy M. investigator.; Kimura Yukiko investigator.; Knibbe W. Patrick investigator.; Lang Bianca A. investigator.; Lindsley Carol B. investigator.; Mitchell Stephen R. investigator.; Moallem Jack investigator.; Olson Judyann C. investigator.; Oral Elif A. investigator.; Pachman Lauren M. investigator.; Passo Murray H. investigator.; Perez Maria D. investigator.; Person Donald A. investigator.; Plotz Paul H. investigator.; Punaro Marilyn G. investigator.; Ray Linda I. investigator.; Rennebohm Robert M. investigator.; Rivas‐Chacon Rafael F. investigator.; Rothman Deborah investigator.; Shaham Bracha investigator.; Sheets Robert M. investigator.; Sherry David D. investigator.; Soep Jennifer investigator.; Sundel Robert P. investigator.; Vogelgesang Scott A. investigator.; Wallace Carol A. investigator.; White Patience H. investigator.; Wu Lan investigator.; Zemel Lawrence S. investigator.;
• Is Part Of: Arthritis & rheumatology. Volume 68:Issue 3(2016)
• Page Start: 761
• Page End: 768
• Publication Date: 2016-03
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/art.39466
• Languages: English
• ISSNs: 2326-5191

Abstract

Abstract : Objective: To identify early factors associated with disease course in patients with juvenile idiopathic inflammatory myopathies (IIMs). Methods: Univariable and multivariable multinomial logistic regression analyses were performed in a large juvenile IIM registry (n = 365) and included demographic characteristics, early clinical features, serum muscle enzyme levels, myositis autoantibodies, environmental exposures, and immunogenetic polymorphisms. Results: Multivariable associations with chronic or polycyclic courses compared to a monocyclic course included myositis‐specific autoantibodies (multinomial odds ratio [OR] 4.2 and 2.8, respectively), myositis‐associated autoantibodies (multinomial OR 4.8 and 3.5), and a documented infection within 6 months of illness onset (multinomial OR 2.5 and 4.7). A higher overall clinical symptom score at diagnosis was associated with chronic or monocyclic courses compared to a polycyclic course. Furthermore, severe illness onset was associated with a chronic course compared to monocyclic or polycyclic courses (multinomial OR 2.1 and 2.6, respectively), while anti‐p155/140 autoantibodies were associated with chronic or polycyclic courses compared to a monocyclic course (multinomial OR 3.9 and 2.3, respectively). Additional univariable associations of a chronic course compared to a monocyclic course included photosensitivity, V‐sign or shawl sign rashes, and cuticular overgrowth (OR 2.2–3.2). The mean ultraviolet index and highest ultraviolet index in the month before diagnosis were associated with a chronic course compared to a polycyclic course in boys (OR 1.5 and 1.3), while residing in the Northwest was less frequently associated with a chronic course (OR 0.2). Conclusion: Our findings indicate that myositis autoantibodies, in particular anti‐p155/140, and a number of early clinical features and environmental exposures are associated with a chronic course in patients with juvenile IIM. These findings suggest that early factors, which are associated with poorer outcomes in juvenile IIM, can be identified.