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Yokoyama T, Inoue N, Sakumura N, Tasaki Y, Wada T. An Adolescent Case of Anti-MDA5 Antibody-Positive Juvenile Dermatomyositis With Interstitial Lung Disease Successfully Treated by Multitarget Therapy Avoiding Cyclophosphamide: A Case Report and Literature Review. Cureus 2024; 16:e62425. [PMID: 39011211 PMCID: PMC11249054 DOI: 10.7759/cureus.62425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2024] [Indexed: 07/17/2024] Open
Abstract
Juvenile dermatomyositis (JDM) patients who test positive for the antimelanoma differentiation-associated gene 5 (MDA5) antibody have a poor prognosis because of rapidly progressing interstitial lung disease (ILD). However, agreement on the best treatment for this condition remains elusive. We encountered a 13-year-old girl with anti-MDA5 antibody-positive JDM who presented with arthritis and was already showing signs of ILD when she was admitted to the hospital. While cyclophosphamide (CY) is commonly used, it can cause gonadal disorders and other complications when administered to adolescent females. Consequently, we chose multitarget therapy, which includes tacrolimus and mycophenolate mofetil. Her ILD and skin symptoms gradually improved, and she was able to maintain remission and avoid CY administration for three years. We conducted a thorough literature review to determine the efficacy and safety of multitarget therapy for anti-MDA5 antibody-positive DM and JDM. Multitarget therapy shows promise as a potentially effective and relatively safe treatment. The ability to avoid CY, which is especially important for adolescent patients concerned about fertility preservation, highlights a significant benefit of this multitarget therapy for anti-MDA5 antibody-positive DM and JDM patients.
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Affiliation(s)
| | - Natsumi Inoue
- Department of Pediatrics, Kanazawa University, Ishikawa, JPN
| | - Naoto Sakumura
- Department of Pediatrics, Kanazawa University, Ishikawa, JPN
| | - Yuko Tasaki
- Department of Pediatrics, Kanazawa University, Ishikawa, JPN
| | - Taizo Wada
- Department of Pediatrics, Kanazawa University, Ishikawa, JPN
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2
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Ye Y, Chen Z, Jiang S, Jia F, Li T, Lu X, Xue J, Lian X, Ma J, Hao P, Lu L, Ye S, Shen N, Bao C, Fu Q, Zhang X. Single-cell profiling reveals distinct adaptive immune hallmarks in MDA5+ dermatomyositis with therapeutic implications. Nat Commun 2022; 13:6458. [PMID: 36309526 PMCID: PMC9617246 DOI: 10.1038/s41467-022-34145-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 10/16/2022] [Indexed: 12/25/2022] Open
Abstract
Anti-melanoma differentiation-associated gene 5-positive dermatomyositis (MDA5+ DM) is an autoimmune condition associated with rapidly progressive interstitial lung disease and high mortality. The aetiology and pathogenesis of MDA5+ DM are still largely unknown. Here we describe the immune signatures of MDA5+ DM via single-cell RNA sequencing, flow cytometry and multiplex immunohistochemistry in peripheral B and T cells and in affected lung tissue samples from one patient. We find strong peripheral antibody-secreting cell and CD8+ T cell responses as cellular immune hallmarks, and over-stimulated type I interferon signaling and associated metabolic reprogramming as molecular immune signature in MDA5+ DM. High frequency of circulating ISG15+ CD8+ T cells at baseline predicts poor one-year survival in MDA5+ DM patients. In affected lungs, we find profuse immune cells infiltration, which likely contributes to the pro-fibrotic response via type I interferon production. The importance of type I interferons in MDA5+ DM pathology is further emphasized by our observation in a retrospective cohort of MDA5+ DM patients that combined calcineurin and Janus kinase inhibitor therapy show superior efficacy to calcineurin inhibitor monotherapy. In summary, this study reveals key immune-pathogenic features of MDA5+ DM and provides a potential basis for future tailored therapies.
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Affiliation(s)
- Yan Ye
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200001, China
| | - Zechuan Chen
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Shan Jiang
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Fengyun Jia
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Teng Li
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xia Lu
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200001, China
| | - Jing Xue
- Department of Rheumatology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Xinyue Lian
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200001, China
| | - Jiaqiang Ma
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Pei Hao
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Liangjing Lu
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200001, China
| | - Shuang Ye
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200001, China
| | - Nan Shen
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200001, China
| | - Chunde Bao
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200001, China
| | - Qiong Fu
- Department of Rheumatology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200001, China.
| | - Xiaoming Zhang
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
- Shanghai Huashen Institute of Microbes and Infections, Shanghai, 200052, China.
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3
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He C, Li W, Xie Q, Yin G. Rituximab in the Treatment of Interstitial Lung Diseases Related to Anti-Melanoma Differentiation-Associated Gene 5 Dermatomyositis: A Systematic Review. Front Immunol 2022; 12:820163. [PMID: 35116041 PMCID: PMC8803653 DOI: 10.3389/fimmu.2021.820163] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/28/2021] [Indexed: 01/10/2023] Open
Abstract
Objective The effectiveness of rituximab in anti-melanoma differentiation-associated gene 5 (MDA5) dermatomyositis (DM) with interstitial lung disease (ILD) has been explored only in isolated case reports and small series. This paper aims to review the current evidence regarding rituximab (RTX) use in the treatment of ILD related to anti-MDA5 DM (anti-MDA5 DM-ILD). Methods We conducted a review by searching PubMed, Web of Science, Embase, and Cochrane for articles with information on patients with anti-MDA5 DM and RTX treatment, published until August 2021, in English language. The selected studies listed variation in chest high-resolution computed tomography (HRCT) and/or pulmonary function test (PFT) as a primary outcome, in patients with anti-MDA5 DM-related ILD after using RTX. Results Of the 145 potentially eligible articles, 17 were selected. The information gathered from a total of 35 patients with anti-MDA5 DM-ILD was reviewed, including 13 men and 22 women. Patient age at onset was 47.60 ± 13.72 years old. A total of 11.43% (4/35) of the patients were found to have chronic ILD (C-ILD) and 88.57% (31/30) exhibited rapidly progressive ILD (RP-ILD). Most patients (29/30) had typical DM rashes. Prior to RTX administration, the majority of patients (27/35) were treated with medium- or high-dose glucocorticoids and at least one additional immunotherapeutic agent. With regard to RTX efficacy for ILD in anti-MDA5 DM, 71.43% (25/35) of the patients responded to treatment. Skin rash also improved in more than half of the patients after RTX treatment. The most common side effects were infections, reported by 37.14% (13/35) of the patients after using RTX. Conclusion As a CD20 targeting drug, RTX is a promising therapeutic tool for anti-MDA5 DM-ILD, although the risk of infections should be considered before treatment. Further prospective controlled studies are required to evaluate the optimal RTX treatment regimen. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021289714, identifier CRD42021289714.
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Affiliation(s)
- Chenjia He
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Wenyu Li
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qibing Xie
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Geng Yin, ; Qibing Xie,
| | - Geng Yin
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Geng Yin, ; Qibing Xie,
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Mehta AA, Paul T, Cb M, Haridas N. Anti-MDA5 antibody-positive dermatomyositis with rapidly progressive interstitial lung disease: report of two cases. BMJ Case Rep 2021; 14:14/4/e240046. [PMID: 33910791 PMCID: PMC8094376 DOI: 10.1136/bcr-2020-240046] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Melanoma differentiation-associated protein 5 (MDA5) antibody-positive dermatomyositis (DM) displays unique cutaneous and pathologic features. We describe two cases of myositis-associated rapidly progressive interstitial lung disease (RP-ILD). The patients were two women from Kerala, India. Both patients had anti-MDA5 antibody-positive myositis. Both patients presented with RP-ILD without any clinical features of myositis and succumbed to their illness despite aggressive medical treatment. Anti-MDA5-antibody-positive DM is characterised by amyopathic disease with rapidly progressive and fatal ILD.
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Affiliation(s)
- Asmita A Mehta
- Department of Respiratory Medicine, Amrita Institute of Medical Science, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Tisa Paul
- Department of Respiratory Medicine, Amrita Institute of Medical Science, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Mithun Cb
- Rheumatology, Amrita Institute of Medical Science, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Nithya Haridas
- Department of Respiratory Medicine, Amrita Institute of Medical Science, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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Rodríguez-Tejero A, López-Espadafor B, Montero-Vílchez T, Sánchez-Díaz M, Arias-Santiago S, Molina-Leyva A. Treatment challenges in clinically amyopathic dermatomyositis: A case series and review of new therapeutic options for skin involvement. Dermatol Ther 2021; 34:e14942. [PMID: 33719170 DOI: 10.1111/dth.14942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 02/21/2021] [Accepted: 03/11/2021] [Indexed: 11/29/2022]
Abstract
The term clinically amyopathic dermatomyositis (CADM) is used to represent a subgroup of patients with the typical cutaneous features of dermatomyositis (DM) in the absence of muscle involvement. Similar to classic DM, CADM can be associated with other connective tissue disorders and systemic manifestations such as interstitial lung disease and malignancy. Owing to the frequent discordance between muscle response and skin disease, the therapeutic approach to CADM represents a challenge. The current literature suggests that CADM treatment should follow a specific protocol, influenced by visceral involvement and the expression of certain myositis-specific antibodies, and different from the recommendation in the presence of myositis. Here, we present five new cases of CADM. We describe the available therapeutic options for skin manifestations in this type of DM, and we propose a step-by-step therapeutic scheme, using the cutaneous dermatomyositis disease area and severity index to assess response. Our literature review establishes mycophenolate mofetil and intravenous immunoglobulin as the most frequently successful therapies in refractory skin disease.
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Affiliation(s)
| | | | | | - Manuel Sánchez-Díaz
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Salvador Arias-Santiago
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Departamento de Dermatología, Facultad de Medicina, Universidad de Granada, Granada, Spain
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Anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis responds to rituximab therapy. Clin Rheumatol 2021; 40:2311-2317. [PMID: 33411136 DOI: 10.1007/s10067-020-05530-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 11/11/2020] [Accepted: 11/29/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The purpose of this study was to assess the efficacy of rituximab (RTX) in the management of anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibody-positive dermatomyositis (DM), with or without rapidly progressive interstitial lung disease (RP-ILD). METHODS Medical records of DM patients with anti-MDA5 antibodies treated with RTX therapy were reviewed retrospectively. Skin rash data, lung function tests, chest high-resolution computed tomography (HRCT), and serum markers were compared before and after RTX. RESULTS Eleven consecutive cases, including 5 males and 6 females, were identified. One hundred percent of patients had a typical DM rash and about 45% presented with skin ulceration. All the patients had ILD, 73% had RP-ILD, and 27% had mild or asymptomatic ILD. Ro-52 antibodies were found in 55% of this group. Lymphopenia was present in 10/11 patients (91%). Around half (55%) had a level of ferritin greater than 1000 ng/ml. Nine patients (82%) were refractory. These patients received intravenous RTX (375 mg/m2) at 0 and 14 days (conventional dose) or 100 mg once a week for 4 weeks (low dose). After RTX treatment, 2 patients (18%) with mild ILD showed complete remission, and 6 (55%) showed improvement in lung HRCT and/or lung function. Skin rash in 4 patients (100%) and ILD in 3 (75%) showed improvement in the low-dose group. Infection episodes occurred in four (57%) and one (25%) of the conventional-dose and low-dose group, respectively. CONCLUSIONS Our study found that RTX is sufficient to improve skin rash and ILD or RP-ILD. Our results also suggest that lower RTX doses may be a useful therapy for anti-MDA5 antibody-positive DM patients. Key Points • To clarify efficacy of RTX in the management of anti-MDA5 antibody-positive DM, we performed a retrospective chart review of DM patients with anti-MDA5 antibodies who were treated with RTX. • This study found that RTX is sufficient to improve skin rash and ILD or RP-ILD. • The results suggest that low-dose RTX in treatment of MDA5-DM results in better responses and fewer adverse events.
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7
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Recommendations for the treatment of anti-melanoma differentiation-associated gene 5-positive dermatomyositis-associated rapidly progressive interstitial lung disease. Semin Arthritis Rheum 2020; 50:776-790. [PMID: 32534273 DOI: 10.1016/j.semarthrit.2020.03.007] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/16/2020] [Accepted: 03/08/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The study aimed to develop evidence-based recommendations for the treatment of rapidly progressive interstitial lung disease (RPILD) associated with the anti-Melanoma Differentiation-Associated Gene 5-positive dermatomyositis (DM) syndrome. METHODS The task force comprised an expert panel of specialists in rheumatology, intensive care medicine, pulmonology, immunology, and internal medicine. The study was carried out in two phases: identifying key areas in the management of DM-RPILD syndrome and developing a set of recommendations based on a review of the available scientific evidence. Four specific questions focused on different treatment options were identified. Relevant publications in English, Spanish or French up to April 2018 were searched systematically for each topic using PubMed (MEDLINE), EMBASE, and Cochrane Library (Wiley Online). The experts used evidence obtained from these studies to develop recommendations. RESULTS A total of 134 studies met eligibility criteria and formed the evidentiary basis for the recommendations regarding immunosuppressive therapy and complementary treatments. Overall, there was general agreement on the initial use of combined immunosuppressive therapy. Combination of high-dose glucocorticoids and calcineurin antagonists with or without cyclophosphamide is the first choice. In the case of calcineurin antagonist contraindication or treatment failure, switching or adding other immunosuppressants may be individualized. Plasmapheresis, polymyxin B hemoperfusion and/or intravenous immunoglobulins may be used as rescue options. ECMO should be considered in life-threatening situations while waiting for a clinical response or as a bridge to lung transplant. CONCLUSIONS Thirteen recommendations regarding the treatment of the anti-MDA5 positive DM-RPILD were developed using research-based evidence and expert opinion.
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8
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Clinical spectrum and therapeutics in Canadian patients with anti-melanoma differentiation-associated gene 5 (MDA5)-positive dermatomyositis: a case-based review. Rheumatol Int 2019; 39:1971-1981. [DOI: 10.1007/s00296-019-04398-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/26/2019] [Indexed: 10/26/2022]
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Waldman R, DeWane ME, Lu J. Dermatomyositis: Diagnosis and treatment. J Am Acad Dermatol 2019; 82:283-296. [PMID: 31279813 DOI: 10.1016/j.jaad.2019.05.105] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/09/2019] [Accepted: 05/11/2019] [Indexed: 12/13/2022]
Abstract
The second article in this continuing medical education series reviews the initial evaluation of patients with suspected dermatomyositis (DM), the relevant work-up for malignancy and interstitial lung disease once a diagnosis of DM is made, and treatment recommendations for patients with DM based on disease severity, the presence of systemic symptoms, and myositis-specific antibody (MSA) profiles. This review emphasizes the emerging role of MSAs in the diagnosis of DM and highlights how MSAs can be used to guide the appropriate work-up for malignancy and interstitial lung disease. The treatment approach proposed by this continuing medical education series discusses both established and novel therapies for DM and highlights the importance of considering lesion type, degree of muscle involvement, presence of systemic symptoms, presence of MSAs, and patient age when determining the best treatment approach for a patient with DM.
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Affiliation(s)
- Reid Waldman
- Department of Dermatology, University of Connecticut, Farmington, Connecticut
| | - Madeline E DeWane
- University of Connecticut, School of Medicine, Farmington, Connecticut
| | - Jun Lu
- Department of Dermatology, University of Connecticut, Farmington, Connecticut.
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10
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Barailler H, Charles S, Goutorbe F, Devaux S. An unusual anti-melanoma differentiation-associated protein 5 amyopathic dermatomyositis. JAAD Case Rep 2019; 5:383-385. [PMID: 31008175 PMCID: PMC6454120 DOI: 10.1016/j.jdcr.2019.02.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - Sophie Charles
- Department of Dermatology, Hôpital Côte Basque, Bayonne, France
| | - Felix Goutorbe
- Department of Gastroenterology, Hôpital Côte Basque, Bayonne, France
| | - Suzanne Devaux
- Department of Dermatology, Hôpital Côte Basque, Bayonne, France
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11
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Abstract
PURPOSE OF REVIEW Anti-melanoma differentiation-associated gene 5 (anti-MDA5) is a novel and highly specific myositis-associated autoantibody, which defines a unique phenotype among patients with dermatomyositis (DM). RECENT FINDINGS Anti-MDA5 was originally characterized in Japan in DM patients with hallmark cutaneous features and no proximal muscle weakness and termed clinically amyopathic DM (CADM). Anti-MDA5 has characteristic cutaneous manifestations which include tender palmar papules and cutaneous ulcerations, along with an increased frequency of interstitial lung disease (ILD) that can be rapidly progressive (RPILD) and fatal. This review will highlight the clinical significance of anti-MDA5 autoantibodies in Caucasian DM patients.
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12
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Effective Administration of Rituximab in Anti-MDA5 Antibody-Positive Dermatomyositis with Rapidly Progressive Interstitial Lung Disease and Refractory Cutaneous Involvement: A Case Report and Literature Review. Case Rep Rheumatol 2017; 2017:5386797. [PMID: 29225988 PMCID: PMC5684540 DOI: 10.1155/2017/5386797] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 09/24/2017] [Indexed: 12/27/2022] Open
Abstract
We describe the case of a 48-year-old man with dermatomyositis (DM) who demonstrated rapidly progressive interstitial lung disease (RP-ILD) and refractory cutaneous involvement together with high levels of anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5-Ab). Even after combination immunosuppressive therapy including a corticosteroid, cyclosporine A, and intravenous cyclophosphamide, his respiratory insufficiency and cutaneous involvement progressively worsened. However, the administration of rituximab (RTX) resulted in clinical remission as well as a visible reduction in anti-MDA5-Ab levels, suggesting that RTX could be a useful remedy in cases refractory to conventional immunosuppressive agents, especially those of RP-ILD related to anti-MDA5-Ab–positive DM.
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Hoa S, Troyanov Y, Fritzler MJ, Targoff IN, Chartrand S, Mansour AM, Rich E, Boudabbouz H, Bourré-Tessier J, Albert M, Goulet JR, Landry M, Senécal JL. Describing and expanding the clinical phenotype of anti-MDA5-associated rapidly progressive interstitial lung disease: case series of nine Canadian patients and literature review. Scand J Rheumatol 2017; 47:210-224. [DOI: 10.1080/03009742.2017.1334814] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S Hoa
- Division of Rheumatology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Y Troyanov
- Division of Rheumatology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Division of Rheumatology, Sacré-Coeur Hospital, Montreal, QC, Canada
| | - MJ Fritzler
- Faculty of Medicine and Mitogen Advanced Diagnostics Laboratory, University of Calgary, Calgary, AB, Canada
| | - IN Targoff
- Department of Medicine, University of Oklahoma, Oklahoma City, OK, USA
| | - S Chartrand
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Division of Rheumatology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada
| | - AM Mansour
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Research Center, Sacré-Coeur Hospital Research Center, Montreal, QC, Canada
| | - E Rich
- Division of Rheumatology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - H Boudabbouz
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Division of Rheumatology, Cité-de-la-Santé Hospital, Laval, QC, Canada
| | - J Bourré-Tessier
- Division of Rheumatology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - M Albert
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Research Center, Sacré-Coeur Hospital Research Center, Montreal, QC, Canada
| | - JR Goulet
- Division of Rheumatology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - M Landry
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Division of Rheumatology, Sacré-Coeur Hospital, Montreal, QC, Canada
| | - JL Senécal
- Division of Rheumatology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
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14
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Tokunaga K, Hagino N. Dermatomyositis with Rapidly Progressive Interstitial Lung Disease Treated with Rituximab: A Report of 3 Cases in Japan. Intern Med 2017; 56:1399-1403. [PMID: 28566605 PMCID: PMC5498206 DOI: 10.2169/internalmedicine.56.7956] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
We performed a retrospective chart review of three patients with hypomyopathic dermatomyositis and rapidly progressive interstitial lung disease. The patients were Japanese women of 71, 69, and 65 years of age. Two patients were anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibody-positive and 1 was anti-aminoacyl-tRNA synthetase (anti-ARS) antibody-positive. Their respiratory statuses deteriorated despite the administration of glucocorticoid, calcineurin inhibitors, and intravenous cyclophosphamide therapy. We subsequently administered rituximab. The anti-ARS antibody-positive patient survived, while 2 anti-MDA5 antibody-positive patients died.
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Affiliation(s)
| | - Noboru Hagino
- Division of Rheumatology, Teikyo University Chiba Medical Center, Japan
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15
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Charbit L, Bursztejn AC, Mohamed S, Kaminsky P, Lerondeau B, Barbaud A, Deibener-Kaminsky J, Schmutz JL. Nécroses digitales étendues au cours d’une dermatomyosite avec anticorps anti-MDA-5. Ann Dermatol Venereol 2016; 143:537-42. [DOI: 10.1016/j.annder.2016.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 02/07/2016] [Accepted: 03/10/2016] [Indexed: 01/09/2023]
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16
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Fasano S, Gordon P, Hajji R, Loyo E, Isenberg DA. Rituximab in the treatment of inflammatory myopathies: a review. Rheumatology (Oxford) 2016; 56:26-36. [PMID: 27121778 DOI: 10.1093/rheumatology/kew146] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 03/04/2016] [Indexed: 12/22/2022] Open
Abstract
Several uncontrolled studies have encouraged the use of rituximab (RTX) in patients with myositis. Unfortunately, the first placebo-phase trial to assess the efficacy of RTX in refractory myositis did not show a significant difference between the two treatment groups, and doubts have been expressed about its study design. In this review we present an up-to-date overview of the reported experiences of RTX therapy in myositis. A PubMed search was performed to find all the available cases of refractory myositis patients treated with RTX up to July 2015. The following terms were assessed: inflammatory myopathies OR anti-synthetase syndrome OR polymyositis OR dermatomyositis AND RTX. A total of 48 studies were included. We identified 458 patients with myositis treated with RTX. We found a rate of response to RTX of 78.3%. RTX can play a role in the management of patients with myositis, at least in those with positive myositis-specific autoantibodies.
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Affiliation(s)
- Serena Fasano
- Rheumatology Unit, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy
| | - Patrick Gordon
- Centre for Rheumatology, Department of Medicine, King's College Hospital, London, UK
| | - Raouf Hajji
- Department of Internal Medicine, Sidi Bouzid Hospital, Ibn Aljazzar Medicine, Faculty of Sousse, Tunisia
| | - Esthela Loyo
- Servicio de Reumatología e Inmunología Clinica HRUJMCB, Jefe de Servicio, Santiago, Rep. Dominicana
| | - David A Isenberg
- Centre for Rheumatology, Department of Medicine, University College London, London, UK
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17
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Kobayashi N, Kobayashi I, Mori M, Sato S, Iwata N, Shigemura T, Agematsu K, Yokota S, Koike K. Increased Serum B Cell Activating Factor and a Proliferation-inducing Ligand Are Associated with Interstitial Lung Disease in Patients with Juvenile Dermatomyositis. J Rheumatol 2015; 42:2412-8. [PMID: 26472413 DOI: 10.3899/jrheum.140977] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Rapidly progressive interstitial lung disease (RP-ILD) is an intractable and fatal complication of juvenile dermatomyositis (JDM). This study evaluated serum levels of B cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) in JDM patients with complicating ILD, and their association with ILD phenotypes, clinical variables, and anti-melanoma differentiation-associated gene 5 (MDA5). METHODS We measured the levels of BAFF, APRIL, and anti-MDA5 in the sera of 23 JDM patients with ILD [8 in the RP-ILD group and 15 in the chronic ILD (C-ILD) group], 17 JDM patients without ILD (non-ILD group), and 10 age-matched controls, using the ELISA method. ILD was identified by high-resolution computed tomography. RESULTS Serum BAFF titers were significantly higher in the JDM patients with RP-ILD versus those with C-ILD (p = 0.011) and in healthy controls (p = 0.0004). The C-ILD group had significantly higher levels of BAFF versus controls (p ≤ 0.0001). Serum APRIL was markedly elevated in the RP-ILD group as compared with the C-ILD group (p = 0.003) and controls (p = 0.006). In patients with ILD, both BAFF and APRIL levels were correlated with serum Krebs von den Lungen-6 and interleukin 18. Subjects with high titer anti-MDA5 (> 200 U) had higher levels of BAFF and APRIL than those with low titer anti-MDA5 (< 100 U; p = 0.019 and p = 0.0029, respectively), which may have been due to a relationship between RP-ILD and high anti-MDA5 titer. CONCLUSION Our findings of markedly elevated levels of BAFF and APRIL in patients with RP-ILD JDM suggest the potential importance of these cytokines in the diagnosis and treatment of RP-ILD accompanying JDM.
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Affiliation(s)
- Norimoto Kobayashi
- From the Department of Pediatrics, and Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University School of Medicine, Matsumoto; Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama; Department of Rheumatology, Tokai University School of Medicine, Isehara; Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Japan.N. Kobayashi, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; I. Kobayashi, MD, PhD, Department of Pediatrics, Hokkaido University Graduate School of Medicine; M. Mori, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; S. Sato, MD, PhD, Department of Rheumatology, Tokai University School of Medicine; N. Iwata, MD, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center; T. Shigemura, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; K. Agematsu, MD, PhD, Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University; S. Yokota, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; K. Koike, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine.
| | - Ichiro Kobayashi
- From the Department of Pediatrics, and Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University School of Medicine, Matsumoto; Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama; Department of Rheumatology, Tokai University School of Medicine, Isehara; Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Japan.N. Kobayashi, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; I. Kobayashi, MD, PhD, Department of Pediatrics, Hokkaido University Graduate School of Medicine; M. Mori, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; S. Sato, MD, PhD, Department of Rheumatology, Tokai University School of Medicine; N. Iwata, MD, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center; T. Shigemura, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; K. Agematsu, MD, PhD, Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University; S. Yokota, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; K. Koike, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine
| | - Masaaki Mori
- From the Department of Pediatrics, and Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University School of Medicine, Matsumoto; Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama; Department of Rheumatology, Tokai University School of Medicine, Isehara; Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Japan.N. Kobayashi, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; I. Kobayashi, MD, PhD, Department of Pediatrics, Hokkaido University Graduate School of Medicine; M. Mori, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; S. Sato, MD, PhD, Department of Rheumatology, Tokai University School of Medicine; N. Iwata, MD, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center; T. Shigemura, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; K. Agematsu, MD, PhD, Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University; S. Yokota, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; K. Koike, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine
| | - Shinji Sato
- From the Department of Pediatrics, and Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University School of Medicine, Matsumoto; Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama; Department of Rheumatology, Tokai University School of Medicine, Isehara; Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Japan.N. Kobayashi, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; I. Kobayashi, MD, PhD, Department of Pediatrics, Hokkaido University Graduate School of Medicine; M. Mori, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; S. Sato, MD, PhD, Department of Rheumatology, Tokai University School of Medicine; N. Iwata, MD, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center; T. Shigemura, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; K. Agematsu, MD, PhD, Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University; S. Yokota, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; K. Koike, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine
| | - Naomi Iwata
- From the Department of Pediatrics, and Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University School of Medicine, Matsumoto; Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama; Department of Rheumatology, Tokai University School of Medicine, Isehara; Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Japan.N. Kobayashi, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; I. Kobayashi, MD, PhD, Department of Pediatrics, Hokkaido University Graduate School of Medicine; M. Mori, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; S. Sato, MD, PhD, Department of Rheumatology, Tokai University School of Medicine; N. Iwata, MD, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center; T. Shigemura, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; K. Agematsu, MD, PhD, Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University; S. Yokota, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; K. Koike, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine
| | - Tomonari Shigemura
- From the Department of Pediatrics, and Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University School of Medicine, Matsumoto; Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama; Department of Rheumatology, Tokai University School of Medicine, Isehara; Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Japan.N. Kobayashi, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; I. Kobayashi, MD, PhD, Department of Pediatrics, Hokkaido University Graduate School of Medicine; M. Mori, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; S. Sato, MD, PhD, Department of Rheumatology, Tokai University School of Medicine; N. Iwata, MD, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center; T. Shigemura, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; K. Agematsu, MD, PhD, Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University; S. Yokota, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; K. Koike, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine
| | - Kazunaga Agematsu
- From the Department of Pediatrics, and Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University School of Medicine, Matsumoto; Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama; Department of Rheumatology, Tokai University School of Medicine, Isehara; Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Japan.N. Kobayashi, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; I. Kobayashi, MD, PhD, Department of Pediatrics, Hokkaido University Graduate School of Medicine; M. Mori, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; S. Sato, MD, PhD, Department of Rheumatology, Tokai University School of Medicine; N. Iwata, MD, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center; T. Shigemura, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; K. Agematsu, MD, PhD, Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University; S. Yokota, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; K. Koike, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine
| | - Shumpei Yokota
- From the Department of Pediatrics, and Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University School of Medicine, Matsumoto; Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama; Department of Rheumatology, Tokai University School of Medicine, Isehara; Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Japan.N. Kobayashi, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; I. Kobayashi, MD, PhD, Department of Pediatrics, Hokkaido University Graduate School of Medicine; M. Mori, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; S. Sato, MD, PhD, Department of Rheumatology, Tokai University School of Medicine; N. Iwata, MD, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center; T. Shigemura, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; K. Agematsu, MD, PhD, Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University; S. Yokota, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; K. Koike, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine
| | - Kenichi Koike
- From the Department of Pediatrics, and Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University School of Medicine, Matsumoto; Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama; Department of Rheumatology, Tokai University School of Medicine, Isehara; Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Japan.N. Kobayashi, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; I. Kobayashi, MD, PhD, Department of Pediatrics, Hokkaido University Graduate School of Medicine; M. Mori, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; S. Sato, MD, PhD, Department of Rheumatology, Tokai University School of Medicine; N. Iwata, MD, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center; T. Shigemura, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine; K. Agematsu, MD, PhD, Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University; S. Yokota, MD, PhD, Department of Pediatrics, Yokohama City University Graduate School of Medicine; K. Koike, MD, PhD, Department of Pediatrics, Shinshu University School of Medicine
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19
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Koichi Y, Aya Y, Megumi U, Shunichi K, Masafumi S, Hiroaki M, Masahiko K, Shinsuke K, Manabu U, Kenichiro H, Fumiaki A, Nozomi A, Toshitaka M, Masayoshi Y, Chikako K, Yoshinao M, Tatsuo S, Masahiko K. A case of anti-MDA5-positive rapidly progressive interstitial lung disease in a patient with clinically amyopathic dermatomyositis ameliorated by rituximab, in addition to standard immunosuppressive treatment. Mod Rheumatol 2015; 27:536-540. [PMID: 25698373 DOI: 10.3109/14397595.2015.1014140] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Rapidly progressive interstitial lung disease (RP-ILD) in patients with clinically amyopathic dermatomyositis (CADM) associated with antibodies to melanoma differentiation-associated gene5 (MDA5) results in a high mortality rate. We experienced a case of anti-MDA5-positive RP-ILD of CADM which showed a response to rituximab, although there was no significant effect due to standard immunosuppressive treatment. This case suggests that rituximab has the potential to offer an effective agent for the treatment of anti-MDA5-positive RP-ILD of CADM.
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Affiliation(s)
- Yamaguchi Koichi
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Yamaguchi Aya
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Uchida Megumi
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Kono Shunichi
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Suzuki Masafumi
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Masubuchi Hiroaki
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Kanbe Masahiko
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Kitahara Shinsuke
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Ueno Manabu
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Hara Kenichiro
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Aoki Fumiaki
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Aoki Nozomi
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Maeno Toshitaka
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Yamanaka Masayoshi
- b Department of Dermatology , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Kishi Chikako
- b Department of Dermatology , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Muro Yoshinao
- c Department of Dermatology , Nagoya University Graduate School of Medicine , Nagoya , Japan
| | - Suga Tatsuo
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
| | - Kurabayashi Masahiko
- a Department of Allergy and Respiratory Medicine , Gunma University Graduate School of Medicine , Maebashi , Japan
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20
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Bodoki L, Nagy-Vincze M, Griger Z, Péter A, András C, Dankó K. [Biological therapy in idiopathic inflammatory myopathies]. Orv Hetil 2014; 155:3-10. [PMID: 24379090 DOI: 10.1556/oh.2014.29787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Idiopathic inflammatory myopathies are systemic, immune-mediated diseases characterized by proximal, symmetrical, progressive muscle weakness. The aim of this work is to give an overview of the biological therapy used in the treatment of idiopathic inflammatory myopathies. The authors also focus on novel results in the therapy directed against the B- and T-cells. They emphasize the importance of new trials in these diseases which may lead to the introduction of novel therapeutic options in these disorders.
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Affiliation(s)
- Levente Bodoki
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Belgyógyászati Intézet, Klinikai Immunológia Tanszék Debrecen Móricz Zsigmond körút 22. 4032
| | - Melinda Nagy-Vincze
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Belgyógyászati Intézet, Klinikai Immunológia Tanszék Debrecen Móricz Zsigmond körút 22. 4032
| | - Zoltán Griger
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Belgyógyászati Intézet, Klinikai Immunológia Tanszék Debrecen Móricz Zsigmond körút 22. 4032
| | - Andrea Péter
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Kardiológiai Klinika Debrecen
| | - Csilla András
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Onkológiai Tanszék Debrecen
| | - Katalin Dankó
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Belgyógyászati Intézet, Klinikai Immunológia Tanszék Debrecen Móricz Zsigmond körút 22. 4032
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Gregoriou S, Giatrakou S, Theodoropoulos K, Katoulis A, Loumou P, Toumbis-Ioannou E, Papadavid E, Avgerinou G, Stavrianeas N, Rigopoulos D. Pilot Study of 19 Patients with Severe Pemphigus: Prophylactic Treatment with Rituximab Does Not Appear to be Beneficial. Dermatology 2014; 228:158-65. [DOI: 10.1159/000357031] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 11/04/2013] [Indexed: 11/19/2022] Open
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