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Evaluation of Interstitial Lung Disease Severity in Patients With Antisynthetase Syndrome According to Specific Autoantibodies Profile

Conditions
Antisynthetase Syndrome
Interventions
Other: Follow-up
Registration Number
NCT04924465
Lead Sponsor
Central Hospital, Nancy, France
Brief Summary

Antisynthetase syndrome (ASS) is an overlap connective tissue disease characterized by the presence of myositis-specific autoantibodies directed against tRNA-synthetases. Clinical manifestations are myositis, interstitial lung disease (ILD), Raynaud's phenomenon, mechanic's hands and polyarthritis. Clinical presentation varies between ASS patients. ASS is potentially life threatening due to lung involvement, especially in rapidly progressive forms. Anti-histidyl-tRNA synthetase (anti-Jo1) antibodies are the most frequently detected antibodies in ASS (60 % of patients). Anti-threonyl-tRNA synthetase (anti-PL7) and alanyl-tRNA synthetase (anti-PL12) antibodies are each detected in 10 % of patients approximatively. Anti-tRNA-synthetases antibodies are mutually exclusive.

Clinical heterogeneity of ASS patients appears to be associated with specific autoantibodies profile. Patients with anti-Jo1 antibodies have a more systemic presentation (especially with muscle involvement), whereas patients with anti-PL7 or anti-PL12 antibodies have more frequent and isolated ILD. If anti-PL7 and anti-PL12 antibodies are associated with more severe ILD and poorer survival is still matter of debate.

Aims of this study were to compare ILD severity at diagnosis and clinical course in patients with ASS according to antisynthetase autoantibodies types.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Patients with antisynthetase syndrome according to Connors criteria
Exclusion Criteria
  • None

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Anti-OJFollow-upPatients with anti-OJ antibodies
Anti-PL12Follow-upPatients with anti-PL12 antibodies
Anti-Jo1Follow-upPatients with anti-Jo1 antibodies
Anti-PL7Follow-upPatients with anti-PL7 antibodies
Anti-EJFollow-upPatients with anti-EJ antibodies
Primary Outcome Measures
NameTimeMethod
Number of patients of rapidly progressive (RP)- ILD3 months

Decrease of at least 10 percent of Forced Vital Capacity (FVC) OR Decrease of at least 5 % of FVC WITH Clinical worsening and/or ILD extension on CT-scan OR Decrease of at least 15 % of Diffusing Capacity of lung for Carbon Monoxide (DLCO) at 3 months of follow-up

Number of patients with severe ILDBaseline

Hypoxemia (PaO2 \< 60 mmHg) AND/OR Oxygen delivery at time of diagnosis

Secondary Outcome Measures
NameTimeMethod
Rate of patients without death or lung transplant3 years and 5 years
Number of patients with ILD relapse3 years and 5 years

Clinical worsening AND/OR ILD extension on CT-scan AND/OR Progressive ILD on pulmonary function tests WITH modification of corticosteroids dosage or immunosuppressive drugs during follow-up

Number of patients with chronic respiratory failure3 years and 5 years

Hypoxemia (PaO2 \< 70 mmHg) in a stable state during follow-up

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