Timing of onset affects arthritis presentation pattern in antisynthetase syndrome

• Published in: Clinical and experimental rheumatology Vol. 36; no. 1; p. 44
• Main Authors: Gonzalez-Gay, MA, Cagnotto, G, Cavagna, L
• Format: Journal Article
• Language: English
• Published: 2018
• Subjects: adult; antibody detection; Antisynthetase syndrome; arthritis; Arthritis pattern; Autoantibodies; autoantibody; azathioprine; biological marker; Biomarkers; blood; bone radiography; Clinical Medicine; clinical trial; cohort analysis; comparative study; controlled study; cyclophosphamide; cyclosporine; disease association; disease classification; disease course; enzyme antibody; Europe; female; fever; follow up; foot disease; hand disease; human; Humans; hydroxychloroquine; immunoglobulin M; immunology; Klinisk medicin; major clinical study; male; Medical and Health Sciences; Medicin och hälsovetenskap; Mexico; middle aged; multicenter study; mycophenolate mofetil; myositis; phenotype; polyarthritis; practice guideline; prednisone; prevalence; priority journal; prognosis; Raynaud phenomenon; Retrospective Studies; retrospective study; Reumatologi och inflammation; rheumatoid factor; Rheumatology and Autoimmunity; risk factor; Risk Factors; synthetase antibody; time factor; Time Factors; Timing of onset; unclassified drug
• ISSN: 1593-098X

Objective To evaluate if the timing of appearance with respect to disease onset may influence the arthritis presentation pattern in antisynthetase syndrome (ASSD). Methods The patients were selected from a retrospective large international cohort of ASSD patients regularly followed-up in centres referring to AENEAS collaborative group. Patients were eligible if they had an antisynthetase antibody testing positive in at least two determinations along with arthritis occurring either at ASSD onset (Group 1) or during the course of the disease (Group 2). Results 445 (70%; 334 females, 110 males, 1 transsexual) out of the 636 ASSD we collected had arthritis, in the majority of cases (367, 83%) from disease onset (Group 1). Patients belonging to Group 1 with respect to Group 2 had an arthritis more commonly polyarticular and symmetrical (p=0.015), IgM-Rheumatoid factor positive (p=0.035), erosions at hands and feet plain x-rays (p=0.036) and more commonly satisfying the 1987 revised classification criteria for rheumatoid arthritis (RA) (p=0.004). Features such as Raynaud's phenomenon, mechanic's hands and fever (e.g. accompanying findings) were more frequently reported in Group 2 (p=0.005). Conclusion In ASSD, the timing of appearance with respect to disease onset influences arthritis characteristics. In particular, RA features are more common when arthritis occurs from ASSD onset, suggesting an overlap between RA and ASSD in these patients. When arthritis appears during the follow-up, it is very close to a connective tissue disease-related arthritis. Also, the different prevalence of accompanying features between these two groups is in line with this possibility. © Clinical and Experimental Rheumatology 2018.