title: Patients with non-Jo-1 anti-tRNA-synthetase autoantibodies have worse survival than Jo-1 positive patients.
abstract: OBJECTIVE
  To compare the cumulative survival and event free survival in patients with Jo-1 versus non-Jo-1 anti-tRNA synthetase autoantibodies (anti-synAb).
  
  
  METHODS
  Anti-synAb positive patients initially evaluated from 1985 to 2009 were included regardless of the connective tissue disease (CTD) diagnosis. Clinical data were extracted from a prospectively collected database and chart review. Survival between Jo-1 and non-Jo-1 was compared by log rank and Cox proportional hazards methods.
  
  
  RESULTS
  202 patients possessed anti-synAb: 122 Jo-1 and 80 non-Jo-1 (35 PL-12; 25 PL-7; 9 EJ; 6 KS; 5 OJ). The diagnoses at first visit for Jo-1 and non-Jo-1 patients were myositis in 83% and 40.0%, overlap or undifferentiated CTD in 17% and 47.5%, and systemic sclerosis in 0% and 12.5%, respectively (p<0.001). The median delay in diagnosis was 0.4 years in Jo-1 patients versus 1.0 year in non-Jo-1 patients (p<0.001). The most common causes of death in the overall cohort were pulmonary fibrosis in 49% and pulmonary hypertension in 11%. The 5- and 10-year unadjusted cumulative survival was 90% and 70% for Jo-1 patients, and 75% and 47% for non-Jo-1 patients (p<0.005). The hazard ratio (HR) of non-Jo-1 patients compared with Jo-1 patients was 1.9 (p=0.01) for cumulative and 1.9 (p=0.008) for event free survival from diagnosis. Age at first diagnosis and diagnosis delay but not gender, ethnicity and CTD diagnosis influenced survival.
  
  
  CONCLUSIONS
  Non-Jo-1 anti-synAb positive patients have decreased survival compared with Jo-1 patients. The difference in survival may be partly attributable to a delay in diagnosis in the non-Jo-1 patients.
authors: Department of Medicine, Division of Rheumatology, University of Pittsburgh School of Medicine, , Pittsburgh, Pennsylvania, USA.
authors: Rohit
authors: R
authors: Aggarwal
authors: Elaine
authors: E
authors: Cassidy
authors: Noreen
authors: N
authors: Fertig
authors: Diane Carol
authors: DC
authors: Koontz
authors: Mary
authors: M
authors: Lucas
authors: Dana P
authors: DP
authors: Ascherman
authors: Chester V
authors: CV
authors: Oddis
mesh_terms: D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D003240:Connective Tissue Diseases / Q000097:blood / Q000276:immunology* / Q000401:mortality*; D005260:Female; D006643:Histidine-tRNA Ligase / Q000276:immunology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data; D016036:Seroepidemiologic Studies
chemical_list: D000974:Antibodies, Antinuclear; D001323:Autoantibodies; C046750:Jo-1 antibody; D006643:Histidine-tRNA Ligase
keywords: Autoantibodies; Dermatomyositis; Outcomes research; Polymyositis