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Triple-combination therapy did not improve prognosis in anti-MDA5 positive dermatomyositis: a multicentre longitudinal cohort study
H. You1, C. Lv2, L. Xu3, L. Wang4, T. Liu5, F. Yuan6, W. Yan7, H. Wei8, J. Wang9, D. Meng10, W. Tan11
- Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
- Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
- Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
- Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
- Department of Rheumatology and Immunology, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China.
- Department of Rheumatology and Immunology, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China.
- Department of Rheumatology, Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu, China.
- Department of Rheumatology, Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu, China.
- Department of Rheumatology, Huai’an First People’s Hospital, Huai’an, Jiangsu, China.
- Department of Rheumatology, Huai’an First People’s Hospital, Huai’an, Jiangsu, China.
- Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. tw2006@njmu.edu.cn
CER17836
2025 Vol.43, N°2
PI 0251, PF 0259
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PMID: 39360352 [PubMed]
Received: 12/05/2024
Accepted : 22/07/2024
In Press: 24/09/2024
Published: 26/02/2025
Abstract
OBJECTIVES:
Anti-melanoma differentiation-associated gene 5-positive dermatomyositis (MDA5+ DM) is frequently linked with interstitial lung disease (ILD), especially the rapidly progressive ILD (RP-ILD). We conduct this research to evaluate the efficacy and safety of triple-combination (triple-combo) therapy consisting of high-dose corticosteroids, tacrolimus and intravenous cyclophosphamide in treating MDA5+ DM patients with ILD.
METHODS:
A multicentre longitudinal cohort study involving 115 MDA5+ DM patients from the Nanjing Medical University Myositis Associated ILD (NMMI) cohort was conducted between January 2019 and November 2022. Patients were categorised into triple-combo and non-triple therapy groups, and their outcomes were assessed.
RESULTS:
Contrary to expectations, triple-combo therapy did not improve the prognosis for MDA5+ DM patients but was linked to increased mortality rates, especially among those at high risk for RP-ILD.
CONCLUSIONS:
Our study suggests that triple-combo therapy might not be effective in improving prognosis in MDA5+ DM patients. Further research is needed to establish safer and more effective treatment modalities for this patient population.
