A unicenter real-world study of the correlation factors for complete clinical response in idiopathic inflammatory myopathies
10.19723/j.issn.1671-167X.2024.02.013
- VernacularTitle:特发性炎性肌病完全临床应答相关因素的单中心真实世界研究
- Author:
Zhanhong LAI
1
;
Jiachen LI
;
Zelin YUN
;
Yonggang ZHANG
;
Hao ZHANG
;
Xiaoyan XING
;
Miao SHAO
;
Yue-Bo JIN
;
Naidi WANG
;
Yimin LI
;
Yuhui LI
;
Zhanguo LI
Author Information
1. 北京大学人民医院风湿免疫科,北京 100044
- Keywords:
Idiopathic inflammatory myopathies;
Clinical response;
Interstitial lung disease;
Risk fac-tors;
Autoantibodies
- From:
Journal of Peking University(Health Sciences)
2024;56(2):284-292
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the correlation factors of complete clinical response in idiopathic inflammatory myopathies(IIMs)patients receiving conventional treatment.Methods:Patients diagnosed with IIMs hospitalized in Peking University People's Hospital from January 2000 to June 2023 were in-cluded.The correlation factors of complete clinical response to conventional treatment were identified by analyzing the clinical characteristics,laboratory features,peripheral blood lymphocytes,immunological indicators,and therapeutic drugs.Results:Among the 635 patients included,518 patients finished the follow-up,with an average time of 36.8 months.The total complete clinical response rate of IIMs was 50.0％(259/518).The complete clinical response rate of dermatomyositis(DM),anti-synthetase syn-drome(ASS)and immune-mediated necrotizing myopathy(IMNM)were 53.5％,48.9％and 39.0％,respectively.Fever(P=0.002)and rapid progressive interstitial lung disease(RP-ILD)(P=0.014)were observed much more frequently in non-complete clinical response group than in complete clinical re-sponse group.The aspartate transaminase(AST),lactate dehydrogenase(LDH),D-dimer,erythrocyte sedimentation rate(ESR),C-reaction protein(CRP)and serum ferritin were significantly higher in non-complete clinical response group as compared with complete clinical response group.As for the treat-ment,the percentage of glucocorticoid received and intravenous immunoglobin(IVIG)were significantly higher in non-complete clinical response group than in complete clinical response group.Risk factor analysis showed that IMNM subtype(P=0.007),interstitial lung disease(ILD)(P=0.001),eleva-ted AST(P=0.012),elevated serum ferritin(P=0.016)and decreased count of CD4+T cells in peripheral blood(P=0.004)might be the risk factors for IIMs non-complete clinical response.Conclu-sion:The total complete clinical response rate of IIMs is low,especially for IMNM subtype.More effec-tive intervention should be administered to patients with ILD,elevated AST,elevated serum ferritin or decreased count of CD4+T cells at disease onset.
