Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 May 12;11(5):e0155381.
doi: 10.1371/journal.pone.0155381. eCollection 2016.

Factors Associated with Interstitial Lung Disease in Patients with Polymyositis and Dermatomyositis: A Systematic Review and Meta-Analysis

Li Zhang  1 , Guoqin Wu  1 , Di Gao  1 , Guijian Liu  2 , Lin Pan  1 , Liyan Ni  3 , Zheng Li  4 , Qiang Wang  1
Affiliations
Review

Factors Associated with Interstitial Lung Disease in Patients with Polymyositis and Dermatomyositis: A Systematic Review and Meta-Analysis

Li Zhang et al. PLoS One. .

Abstract

Objectives: Interstitial lung disease (ILD) is an extramuscular manifestation that results in increased morbidity and mortality from polymyositis (PM) and dermatomyositis (DM). The aim of this study was to systematically evaluate risk factors associated with the development of ILD in PM/DM.

Methods: Observational studies were identified from searching PubMed, Medline, Embase, and the Cochrane Library. Pooled odds ratios (ORs) or standardized mean differences (SMDs) and corresponding 95% confidence intervals (CIs) were obtained for the relationships between risk factors and ILD in PM/DM using either fixed- or random-effects models, whichever were appropriate. Heterogeneity tests, sensitivity analyses, and publication bias assessments were also performed.

Results: Twenty-three studies were selected for a meta-analysis that included 834 patients and 1245 control subjects. Risk factors that may have increased the risk of developing ILD in PM/DM patients included older age at diagnosis (SMD, 0.35; 95% CI, 0.18-0.52; P < 0.0001), arthritis/arthralgia (OR, 3.17; 95% CI, 1.99-5.04; P < 0.00001), fever (OR, 2.31; 95% CI, 1.42-3.76; P = 0.0007), presence of anti-Jo-1 antibodies (OR, 3.34; 95% CI, 2.16-5.16; P < 0.00001), elevated erythrocyte sedimentation rate (ESR; SMD, 0.48; 95% CI, 0.32-0.64; P < 0.00001), presence of anti-MDA5 antibodies (OR, 18.26; 95% CI, 9.66-34.51; P < 0.00001), and elevated C-reactive protein level (CRP; OR, 3.50; 95% CI, 1.48-8.28; P = 0.004). Meanwhile, malignancy (OR, 0.36; 95% CI, 0.18-0.72; P = 0.004) reduced the risk of developing ILD in PM/DM patients.

Conclusion: Our meta-analysis results suggest that the association between PM/DM and ILD may be due to such risk factors as older age at diagnosis, arthritis/arthralgia, fever, presence of anti-Jo-1 antibodies, elevated ESR, presence of anti-MDA5 antibodies, and elevated CRP level, while malignancy was associated with a reduced risk of developing ILD. Thus, these variables may be used to guide screening processes for ILD in patients with PM/DM.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. A flow diagram of the studies.
Fig 2
Fig 2. Forest plots generated by meta-analysis for the significant findings about demographics from the studies.
(A) Age at diagnosis.
Fig 3
Fig 3. Forest plots generated by meta-analysis for the significant findings about clinical features from the studies.
(A)heliotrope rash. (B) arthritis/arthralgia. (C) Malignancy. (D) fever.
Fig 4
Fig 4. Forest plots generated by meta-analysis for the significant findings about lab tests from the studies.
(A) anti-Jo-1 antibody. (B) ESR. (C) MDA5. (D) CRP.
Fig 5
Fig 5. Sensitivity Analysis of the studies.
(A) arthritis/arthralgia. (B) Raynaud's phenomenon. (C) dysphagia. (D) ANA.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Troyanov Y, Targoff IN, Payette MP, Raynauld JP, Chartier S, Goulet JR, et al. (2014) Redefining dermatomyositis: a description of new diagnostic criteria that differentiate pure dermatomyositis from overlap myositis with dermatomyositis features. Medicine (Baltimore) 93: 318–332. - PMC - PubMed
    1. Marie I, Hatron PY, Dominique S, Cherin P, Mouthon L, Menard JF (2011) Short-term and long-term outcomes of interstitial lung disease in polymyositis and dermatomyositis: a series of 107 patients. Arthritis Rheum 63: 3439–3447. 10.1002/art.30513 - DOI - PubMed
    1. Hallowell RW, Ascherman DP, Danoff SK (2014) Pulmonary manifestations of polymyositis/dermatomyositis. Semin Respir Crit Care Med 35: 239–248. 10.1055/s-0034-1371528 - DOI - PubMed
    1. Connors GR, Christopher-Stine L, Oddis CV, Danoff SK (2010) Interstitial lung disease associated with the idiopathic inflammatory myopathies: what progress has been made in the past 35 years? Chest 138: 1464–1474. 10.1378/chest.10-0180 - DOI - PubMed
    1. Feng Y, Ni L, Wang Q (2013) Administration of cathepsin B inhibitor CA-074Me reduces inflammation and apoptosis in polymyositis. J Dermatol Sci 72: 158–167. 10.1016/j.jdermsci.2013.06.014 - DOI - PubMed

Grants and funding

The authors have no support or funding to report.