Cytosolic 5'-nucleotidase 1A autoantibody profile and clinical characteristics in inclusion body myositis

J B Lilleker, A Rietveld, S R Pye, K Mariampillai, O Benveniste, M T J Peeters, J A L Miller, M G Hanna, P M Machado, M J Parton, K R Gheorghe, U A Badrising, I E Lundberg, S Sacconi, M K Herbert, N J McHugh, B R F Lecky, C Brierley, D Hilton-Jones, J A LambM E Roberts, R G Cooper, C G J Saris, G J M Pruijn, H Chinoy, B G M van Engelen, all UKMYONET contributors

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Abstract

OBJECTIVES: Autoantibodies directed against cytosolic 5'-nucleotidase 1A have been identified in many patients with inclusion body myositis. This retrospective study investigated the association between anticytosolic 5'-nucleotidase 1A antibody status and clinical, serological and histopathological features to explore the utility of this antibody to identify inclusion body myositis subgroups and to predict prognosis.

MATERIALS AND METHODS: Data from various European inclusion body myositis registries were pooled. Anticytosolic 5'-nucleotidase 1A status was determined by an established ELISA technique. Cases were stratified according to antibody status and comparisons made. Survival and mobility aid requirement analyses were performed using Kaplan-Meier curves and Cox proportional hazards regression.

RESULTS: Data from 311 patients were available for analysis; 102 (33%) had anticytosolic 5'-nucleotidase 1A antibodies. Antibody-positive patients had a higher adjusted mortality risk (HR 1.89, 95% CI 1.11 to 3.21, p=0.019), lower frequency of proximal upper limb weakness at disease onset (8% vs 23%, adjusted OR 0.29, 95% CI 0.12 to 0.68, p=0.005) and an increased prevalence of excess of cytochrome oxidase deficient fibres on muscle biopsy analysis (87% vs 72%, adjusted OR 2.80, 95% CI 1.17 to 6.66, p=0.020), compared with antibody-negative patients.

INTERPRETATION: Differences were observed in clinical and histopathological features between anticytosolic 5'-nucleotidase 1A antibody positive and negative patients with inclusion body myositis, and antibody-positive patients had a higher adjusted mortality risk. Stratification of inclusion body myositis by anticytosolic 5'-nucleotidase 1A antibody status may be useful, potentially highlighting a distinct inclusion body myositis subtype with a more severe phenotype.

Original languageEnglish
JournalAnnals of the Rheumatic Diseases
Volume76
Issue number5
Early online date25 Jan 2017
DOIs
Publication statusPublished - 1 May 2017

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