ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2372

Timing of Onset and Cluster with Other Manifestations Influence the Spectrum of Arthritis in Anti Jo-1 Positive Antisynthetase Syndrome: Results from a Multicenter, International, Retrospective Study

Alberto Sifuentes Giraldo1, Carlo Alberto Scirè2, Santos Castañeda3, Laura Nuño4, Francisco Javier Lopez Longo5, Julia Martínez-Barrio5, Franco Franceschini6, Ilaria Cavazzana6, Paolo Airò7, Elena Bartoloni Bocci8, Javier Bachiller Corral9, Rossella Neri10, Simone Barsotti11, Roberto Caporali12, Carlomaurizio Montecucco13, Marcello Govoni14, Renato La Corte14, Federica Furini14, Florenzo Iannone15, Margherita Giannini16, Enrico Fusaro17, Simone Parisi18, Giuseppe Paolazzi19, Giovanni Barausse19, Raffaele Pellerito20, Alessandra Russo20, Lesley Ann Saketkoo21, Norberto Ortego-Centeno22, Luca Quartuccio23, Christof Specker24, Andreas Schwarting25, Kostantinos Triantafyllias26, Carlo Selmi27, Fausto Salaffi28, Marco Amedeo Cimmino29, Annamaria Iuliano30, Fabrizio Conti31, Gianluigi Baiocchi32, Elena Bravi33, Veronica Codullo12, Anna Ghirardello34, Trinitario Pina35, Miguel Angel Gonzalez-Gay35, Lorenzo Cavagna13 and AENEAS (American and European NEtwork of Antisynthetase Syndrome) collaborative group, 1Department of Rheumatology, University Hospital Ramón y Cajal, Madrid, Spain, 2Epidemiology Unit – Italian Society for Rheumatology (SIR), Milano, Italy, 3Rheumatology, H.U. La Princesa, Madrid, Spain, 4Servicio de Reumatologia, Hospital Universitario La Paz, Madrid, Spain, 5Servicio de Reumatologia, Hospital General Universitario Gregorio Marañón, Madrid, Spain, 6Rheumatology and Clinical Immunology, Spedali Civili and University of Brescia, Brescia, Italy, 7Rheumatology Unit, Spedali Civili of Brescia, Brescia, Italy, 8Rheumatology Unit, Department of Clinical & Experimental Medicine, University of Perugia, Perugia, Italy, 9Rheumatology, University Hospital Ramón y Cajal, Madrid, Spain, 10Rheumatology Unit, University of Pisa, Italy, Pisa, Italy, 11Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy, 12Division of Rheumatology, University of Pavia, IRCCS Foundation Policlinico S. Matteo, Pavia, Italy, 13Division of Rheumatology, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy, 14UOC Reumatologia, Azienda Ospedaliera Universitaria S. Anna, Ferrara, Italy, 15Interdisciplinary Department of Medicine (DIM), Rheumatology Unit, University of Bari, Bari, Italy, 16DIM, Rheumatology Unit, Bari, Italy, 17Department of Rheumatology, Città della Salute e della Scienza, Torino, Italy, 18Department of Rheumatology, Città Della Salute e della Scienza, Torino, Italy, 19Rheumatology Unit, Santa Chiara Hospital, Trento, Italy, 20Division of Rheumatology, Mauriziano Hospital, Turin, Italy, 21Tulane University Lung Center, New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, LA, 22Systemic Autoimmune Diseases Unit, Hospital Universitario San Cecilio, Granada, Spain, 23Clinic of Rheumatology, Department of Medical and Biological Sciences (DSMB), Santa Maria della Misericordia Hospital, University of Udine, Udine, Italy, 24Department for Rheumatology and Clinical Immunology, St. Josef Krankenhaus, University Clinic, Essen, Germany, 25Department of Internal Medicine, Rheumatology and Clinical Immunology, University Hospital Johannes-Gutenberg, Mainz, Germany, 26ACURA Rheumatology Center, Bad Kreuznach, Germany, 27Internal Medicine- Unit of Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center, Rozzano, Italy, 28Rheumatology Department, Polytechnic University of Marche, C. Urbani Hospital, Jesi,, Ancona, Italy, 29Research Laboratory and Academic Unit of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy, 30Osp. San Camillo, Roma, Italy, 31Rheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy, 32Rheumatology Unit, Department of Internal Medicine, S.Maria Hospital –IRCCS, Reggio Emilia, Italy, 33Internal Medicine, Rheumatology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy, 34Department of Medicine-DIMED, University of Padova, Padova, Italy, 35Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Santander, Spain

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: , , ,

Session Information

Date: Tuesday, November 10, 2015

Title: Muscle Biology, Myositis and Myopathies Poster II: Autoantibodies and Treatments in Inflammatory Myopathies

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: arthritis, myositis and interstitial lung disease (ILD) are
reported in up to 90% of patients affected by antisynthetase syndrome (ASSD)
and thus represent the most common manifestations of this rare condition.
Arthritis presentation ranges from symmetrical polyarthritis to
oligoarticular/asymmetrical arthritis. IgM-rheumatoid factor (RF) and
anti-cyclic citrullinated peptide antibodies (ACPA) may be positive, and joint
erosions mat be observed at plain radiographs of hands and feet. On this basis,
in ASSD differential diagnosis with rheumatoid arthritis (RA) may be challenging.
Arthritis may occur at disease onset, with or without myositis and/or ILD, or
during the follow-up. The aim of this multicenter, international, retrospective
study was to assess whether in ASSD the timing and the cluster of onset with
other typical disease manifestations may influence arthritis characteristics

Methods: anti Jo-1 positive patients presenting with arthritis (joints swelling
and tenderness required) were included in the study. Clinical, radiology and
laboratory characteristics of arthritis and the occurrence of myositis and ILD,
were retrospectively reviewed. Patients were divided in 3 groups: Group 1)
isolated arthritis at disease onset, Group 2) arthritis associated with myositis
and/or ILD at disease onset, Group 3) arthritis occurrence after disease onset

Results: the starting cohort included 252 anti Jo-1 positive ASSD. Arthritis was identified
in 186 (74%) cases and it was mainly polyarticular and symmetrical (120, 65%).
The remaining patients (64, 36%) had an oligoarticular/asymmetrical arthritis.
RF-IgM was positive in 54/154 patients tested (30%). ACPA were positive in 19/139
patients tested (14%). Hands and feet plain radiographs were available in 179
patients, in 39 cases (22%) with evidence of erosions. Anti Ro antibodies were
positive in 102/180 patients tested (57%). Patients’ characteristics and
statistical significances between groups are shown in table 1. Symmetrical
polyarthritis was the main pattern of presentation in all groups. Ig-M RF
positive and joint erosions were less common in patients without arthritis at
disease onset (Group 3) than in those presenting with isolated arthritis (Group
1). ACPA and joint erosions were more common in Group 1 than in Group 2

Conclusion: in anti Jo-1 positive ASSD, the timing and the cluster of
appearance influence arthritis features. According to our findings, heterogeneity
within the clinical spectrum of arthritis is one of the main characteristics of
anti Jo-1 positive ASSD. Typical RA features are more common at disease onset
and in patients presenting with isolated arthritis

References

Cavagna L, et al. Ann Rheum Dis 2015;74(S2):
601

 

 

 

Group 1 : isolated arthriris at disease onset

Group 2: arthritis associated with myositis and/or ILD at disease onset

Group 3: arthritis occurrence after disease onset ^

Number (% of total)

60 (32)

97 (52)

29 (16)

Median age in years at disease onset (IQR)

54.5 (43-62.5)

53 (43-61)

52 (39.5-66.5)

p=0.824 µ

Median follow-up in months (IQR)

86.5 (60-150)

75 (32.5-132)

130 (66-225)

p=0.007 µ

reference

p=0.075*

p=0.079*

Males/females

13/47

25/72

6/23

p=0.774

Symmetrical polyarthritis (% of subset)

41 (68)

61 (63)

17 (59)

p=0.636

IgM-RF positive/patients checked (% of subset)

24/59 (41)

26/93 (28)

4/29 (14)

p=0.023

reference

p=0.147

p=0.030

ACPA positive/patients checked (% of subset)

13/49 (26.5)

5/71 (7)

1/19

p=0.005

reference

p=0.007

p=0.107

Joint erosions/patients checked (% of subset)

20/59 (34)

16/92 (17)

3/28 (11)

p=0.013

reference

p=0.024

p=0.042

Anti-Ro positive/patients checked (% of subset)

29/60 (48)

58/91 (64)

15/29 (52)

p=0.147

 

 

 

 

 

Table 1: different characteristics of patients according to arthritis timing of onset and cluster with other manifestions. Legend: ILD= interstitial lung disease; IQR= interquartile range; RF= rheumatoid factor; ACPA= anti-cyclic citrullinated peptide antibodies. Statistical analysis: µ Kruskal Wallis, * Mann-Whitney test, other Chi-square test.                                                                                                                                                                ^  median time to arthritis appearance from disease onset in Group 3: 14 months (Interquartile range 6-32).

 

 

Disclosure: A. Sifuentes Giraldo, None; C. A. Scirè, None; S. Castañeda, None; L. Nuño, None; F. J. Lopez Longo, None; J. Martínez-Barrio, None; F. Franceschini, None; I. Cavazzana, None; P. Airò, None; E. Bartoloni Bocci, None; J. Bachiller Corral, None; R. Neri, None; S. Barsotti, None; R. Caporali, UCB, Roche, 8,AbbVie, Pfizer, MSD, 5; C. Montecucco, None; M. Govoni, None; R. La Corte, None; F. Furini, None; F. Iannone, None; M. Giannini, None; E. Fusaro, None; S. Parisi, None; G. Paolazzi, None; G. Barausse, None; R. Pellerito, None; A. Russo, None; L. A. Saketkoo, None; N. Ortego-Centeno, None; L. Quartuccio, None; C. Specker, None; A. Schwarting, None; K. Triantafyllias, None; C. Selmi, None; F. Salaffi, None; M. A. Cimmino, None; A. Iuliano, None; F. Conti, None; G. Baiocchi, None; E. Bravi, None; V. Codullo, None; A. Ghirardello, None; T. Pina, None; M. A. Gonzalez-Gay, None; L. Cavagna, None.

To cite this abstract in AMA style:

Sifuentes Giraldo A, Scirè CA, Castañeda S, Nuño L, Lopez Longo FJ, Martínez-Barrio J, Franceschini F, Cavazzana I, Airò P, Bartoloni Bocci E, Bachiller Corral J, Neri R, Barsotti S, Caporali R, Montecucco C, Govoni M, La Corte R, Furini F, Iannone F, Giannini M, Fusaro E, Parisi S, Paolazzi G, Barausse G, Pellerito R, Russo A, Saketkoo LA, Ortego-Centeno N, Quartuccio L, Specker C, Schwarting A, Triantafyllias K, Selmi C, Salaffi F, Cimmino MA, Iuliano A, Conti F, Baiocchi G, Bravi E, Codullo V, Ghirardello A, Pina T, Gonzalez-Gay MA, Cavagna L. Timing of Onset and Cluster with Other Manifestations Influence the Spectrum of Arthritis in Anti Jo-1 Positive Antisynthetase Syndrome: Results from a Multicenter, International, Retrospective Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/timing-of-onset-and-cluster-with-other-manifestations-influence-the-spectrum-of-arthritis-in-anti-jo-1-positive-antisynthetase-syndrome-results-from-a-multicenter-international-retrospective-study/. Accessed .

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