Can anti-MDA5 antibody-related myopathy be diagnosed according to EULAR/ACR criteria?

*Only medical professionals can read and refer to clinical information, reachable in 1s ▎Clinical question: How does the 2017 EULAR/ACR classification standard perform in the diagnosis of anti-MDA5 antibody-related idiopathic inflammatory myopathy (IIM)? Screenshot of the literature▎Research protocol: Adult patients clinically diagnosed with anti-MDA5 antibody-related IIM from 10 hospitals in Hong Kong, China were retrospectively recruited
.

Clinical characteristics of all patients were collected from electronic medical records, and myositis-specific autoantibodies (MSA) were detected by western blotting
.

The performance of the 2017 EULAR/ACR classification criteria was tested
.

Anti-MDA5 antibodies were then included in the EULAR/ACR criteria and the MSA-based criteria proposed by Casal-Dominguez et al.
for evaluation, and finally a new set of anti-MDA5-specific phenotype-serological classification criteria was proposed
.

▎Main findings: 120 patients with anti-MDA5-related IIM were recruited, and the subgroups were only dermatomyositis (DM, 31.
7%) and amyopathic dermatomyositis (CADM, 68.
3%)
.

86 (71.
7%) and 49 (40.
8%) patients met EULAR/ACR classification criteria and Bohan & Peter criteria, respectively
.

Adding Sontheimer's CADM criteria, 76.
7% of patients could be classified according to Bohan and Peter criteria
.

If anti-MDA5 antibody is used as one of the criteria, the sensitivity of EULAR/ACR criteria can be increased to 98.
3%
.

The criteria of Casal-Dominguez et al.
had 100% sensitivity in this cohort
.

▎Deficiencies and prospects: Almost 30% of clinical anti-MDA5 antibody-related IIM patients cannot be classified according to EULAR/ACR criteria
.

It is proposed to add anti-MDA5 antibodies to existing criteria or to develop new "anti-MDA5 syndrome" specific criteria
.

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