Risk of Malignancy in Dermatomyositis with Anti-CADM-140/ Melanoma Differentiation- Associated Gene 5 Autoantibody

Shinji Sato¹, Takayoshi Kurabayashi¹, Sho Sasaki², Yasushi Koyama², Shinichi Nogi³, Naofumi Chinen¹, Chiho Yamada¹ and Yasuo Suzuki¹, ¹Internal Medicine/ Rheumatology, Tokai University School of Medicine, Isehara, Japan, ²Internal Medicine/Rheumatology, Tokai University School of Medicine, Isehara, Japan, ³Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Antibodies, dermatomyositis and malignancy

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: Anti-CADM-140/ Melanoma Differentiation-Associated Gene 5 (MDA5) antibody is found specifically in patients with dermatomyositis (DM). This autoantibody is associated with clinically amyopathic DM (CADM) and rapidly progressive interstitial lung disease especially in eastern Asian population. However, the association of malignancy and anti-CADM-140/ MDA5 antibody had not been examined in detail. Aim of this study is to determine the association between cancer-associated myositis (CAM) and anti-CADM-140/ MDA5 antibody in Japanese patients.

Methods: Sixty-two patients with classic DM or CADM who were seen at our University from 2011 to 2014 were retrospectively evaluated for the associations between anti-CADM-140/ MDA5 antibody and the occurrence of malignancy. CAM was defined as a patient having a cancer within 5 years of DM diagnosis. Anti-CADM-140/ MDA5 antibody were examined by protein immunoprecipitation assay and enzyme-linked immunosorbent assay. Comparisons between two groups were made using the chi-square test.

Results: Of 62 patients, 44 patients were diagnosed as having classic DM (male/female: 15/29, a mean age ± SD: 56.8 ± 13.5) and 18 were diagnosed as having CADM (male/female: 3/15, a mean age ± SD: 54.3 ± 9.6). Sera from 3 patients with classic DM and all 18 patients with CADM were found to contain anti-CADM-140/ MDA5 antibody (6.8%; 3/44 vs. 100%; 18/18, P< 0.0001). CAM was seen in 25.0% (11/44) of classic DM as compared to 5.6 % (1/18) of CADM (P = 0.15). Malignancies in classic DM included lung (3 patients), colon (2 patients) and bladder, lymphoma, breast, oropharynx, external auditory canal and unknown (1 patient each) while CADM included colon (1 patient). CAM was found in only one patient with anti-CADM-140/ MDA5 antibody positive, whereas 11 patients with anti-CADM-140/ MDA5 antibody negative (4.8% 1/21 vs. 26.8% 11/41, P= 0.046).

Conclusion: Anti-CADM-140/ MDA5 antibody was significantly found with a high frequency in patients with CADM as compared to those with classic DM. Malignancy was significantly less found in DM patients with anti-CADM-140/ MDA5 antibody compared with those without this antibody. These results suggest that DM patients with anti-CADM-140/ MDA5 antibody might have a low risk of malignancy.

Disclosure: S. Sato, Holding a patent on anti- MDA5 antibody-measuring kit., 7; T. Kurabayashi, None; S. Sasaki, None; Y. Koyama, None; S. Nogi, None; N. Chinen, None; C. Yamada, None; Y. Suzuki, None.

To cite this abstract in AMA style:

Sato S, Kurabayashi T, Sasaki S, Koyama Y, Nogi S, Chinen N, Yamada C, Suzuki Y. Risk of Malignancy in Dermatomyositis with Anti-CADM-140/ Melanoma Differentiation- Associated Gene 5 Autoantibody [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/risk-of-malignancy-in-dermatomyositis-with-anti-cadm-140-melanoma-differentiation-associated-gene-5-autoantibody/. Accessed .

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