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Antinuclear antibody negativity ups risk of malignancy in adult-onset dermatomyositis

08 May 2019

Antinuclear antibody (ANA) negativity appears to increase the likelihood of developing malignancy in patients with adult-onset dermatomyositis (DM) within 3 years of diagnosis of their DM, according to a recent study.

“Particularly close follow-up and frequent malignancy screening may be warranted in ANA individuals with DM,” the authors said.

This retrospective cohort study compared the incidence of amyopathic disease, risk of malignancy and clinical findings in ANA+ and ANA patients with adult-onset DM, determined by enzyme-linked immunosorbent assay.

A total of 231 patients were included, of whom 140 (61 percent) were ANA+ and 91 (39 percent) were ANA. The frequency of dysphagia (15 percent vs 26 percent; p=0.033) and heliotrope rash (38 percent vs 53 percent; p=0.026) was lower in ANA+ patients compared with ANA patients.

Overall, malignancy developed in 54 patients (23 percent) within 3 years of diagnosis of DM. More ANA patients developed malignancy than ANA+ patients (43 percent vs 11 percent; p<0.001).

In multivariable analysis, ANA positivity was strongly associated with a lower likelihood of malignancy (odds ratio [OR], 0.16; p<0.001). In contrast, there was no association found between ANA positivity and amyopathic disease (OR, 0.94; p=0.87).

This study was limited by its retrospective nature, according to the authors.

An earlier study by Fardet and colleagues found the following factors to be independently associated with an underlying malignancy in DM patients: age at diagnosis >52 years (hazard ratio [HR], 7.24; 95 percent CI, 2.35–22.31), a rapid onset of skin and/or muscular symptoms (HR, 3.11; 1.07–9.02), presence of skin necrosis (HR, 3.84; 1.00–14.85) or periungual erythema (HR, 3.93; 1.16–13.24) and a low baseline level of complement factor C4 (HR, 2.74; 1.11–6.75). [Medicine (Baltimore) 2009;88:91-97]

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Most Read Articles
Pearl Toh, 10 Oct 2019
Adding a LAMA* to the double combination therapy of ICS** plus LABA*** in a single inhaler improves lung function and reduces exacerbations in patients whose asthma is inadequately controlled with the combination treatment, according to the TRIMARAN and TRIGGER# studies presented at ERS 2019.
4 days ago
Eating alone may help in weight management as findings of a recent study suggest that eating with friends lead to higher food intake.
Tristan Manalac, 3 days ago
A digital-first approach, iConnect, allows patients to have greater access to services and guidance and enables healthcare providers to deliver much better postdischarge care, according to Lim Cher Wee, chief operating officer of the Ministry of Health, Office for Healthcare Transformation of Singapore, in his presentation at the recently concluded AsiaPac19 Conference & Exhibition of the Healthcare Information and Management Systems Society (HIMSS 2019).
Jairia Dela Cruz, 3 days ago
Toileting behaviours such as convenience and delayed voiding, straining to void, and position preference are strongly associated with overactive bladder (OAB) symptoms in women, according to a study.