Objectives The rarity of myositis-specific antibodies (MSAs) presents challenges in the assessment of idiopathic inflammatory myopathy (IIM) subsets. We leveraged a national database to identify MSA-positive veterans and compare all-cause mortality across antibody subsets in a singular population. Methods A retrospective analysis of veteran adults with MSA testing between 1/1/2011 and 12/31/2021 was performed. A minimum of two outpatient International Classification of Disease 9 or 10 visit codes from specialty clinics at least 30 days apart with one creatine phosphokinase level above the upper limit of normal was used to assign a presumptive IIM diagnosis. Current Procedural Terminology codes were used to identify lung computerized tomography imaging studies. Kaplan–Meier survival and Cox proportional regression analyses were performed for the primary outcome of mortality from any cause with a censor date of 12/10/2023. Results A total of 1749 veterans met inclusion criteria. Jo-1 was the most common MSA (75.0%), followed by PL-7 (8.9%) and HMGCR (3.5%). Our cohort was male-predominant (83.4%) with a robust representation of non-White veterans (47.3%). Jo-1 individuals had longer survival compared to non-Jo-1 (75% survival at 6.5 years, 95% CI 5.8–7.1 vs 3.4 years, 95% CI 2.7–5.2, log rank p < 0.001). Univariate and multivariable Cox proportional hazard analyses showed that non-Jo-1 status was associated with higher mortality, irrespective of antibody titer. There were no sex differences in mortality or lung disease prevalence. Conclusions Age, lung involvement, and non-Jo-1 MSA status are associated with increased veteran mortality in this large, male-predominant cohort. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec colname="c1" colnum="1" /> <colspec colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Key Points • Jo-1 antibody positivity was associated with the best survival among MSA subsets. • The incidence of lung involvement was equal among Jo-1-positive men and women. • Veteran survival was chiefly determined by MSA subtype, irrespective of antibody titer. </entry> </row> </tbody> </tgroup> </Table>

Retrospective analysis of myositis-specific antibody-positive veteran survival between 2011 and 2023

期刊论文
发表日期：

2025年11月25日

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Koichi Yamaguchi,
Siamak Moghadam-Kia,
Rohit Aggarwal,
Chester V. Oddis,
Dana P. Ascherman,
Vladimir M. Liarski

摘要

Objectives

The rarity of myositis-specific antibodies (MSAs) presents challenges in the assessment of idiopathic inflammatory myopathy (IIM) subsets. We leveraged a national database to identify MSA-positive veterans and compare all-cause mortality across antibody subsets in a singular population.

Methods

A retrospective analysis of veteran adults with MSA testing between 1/1/2011 and 12/31/2021 was performed. A minimum of two outpatient International Classification of Disease 9 or 10 visit codes from specialty clinics at least 30 days apart with one creatine phosphokinase level above the upper limit of normal was used to assign a presumptive IIM diagnosis. Current Procedural Terminology codes were used to identify lung computerized tomography imaging studies. Kaplan–Meier survival and Cox proportional regression analyses were performed for the primary outcome of mortality from any cause with a censor date of 12/10/2023.

Results

A total of 1749 veterans met inclusion criteria. Jo-1 was the most common MSA (75.0%), followed by PL-7 (8.9%) and HMGCR (3.5%). Our cohort was male-predominant (83.4%) with a robust representation of non-White veterans (47.3%). Jo-1 individuals had longer survival compared to non-Jo-1 (75% survival at 6.5 years, 95% CI 5.8–7.1 vs 3.4 years, 95% CI 2.7–5.2, log rank p < 0.001). Univariate and multivariable Cox proportional hazard analyses showed that non-Jo-1 status was associated with higher mortality, irrespective of antibody titer. There were no sex differences in mortality or lung disease prevalence.

Conclusions

Age, lung involvement, and non-Jo-1 MSA status are associated with increased veteran mortality in this large, male-predominant cohort.

Key Points

• Jo-1 antibody positivity was associated with the best survival among MSA subsets.

• The incidence of lung involvement was equal among Jo-1-positive men and women.

• Veteran survival was chiefly determined by MSA subtype, irrespective of antibody titer.