Prevalence of interstitial lung disease in polymyositis and dermatomyositis: A meta-analysis from 2000 to 2020

• Published in: Seminars in arthritis and rheumatism Vol. 51; no. 1; pp. 175 - 191
• Main Authors: Sun, Kun-Yan, Fan, Yong, Wang, Yun-Xia, Zhong, Yi-Jue, Wang, Guang-Fa
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2021
• Subjects: Clinically amyopathic dermatomyositis; Dermatomyositis; Dermatomyositis - complications; Dermatomyositis - epidemiology; Humans; Interstitial lung disease; Lung Diseases, Interstitial - epidemiology; Lung Diseases, Interstitial - etiology; Meta-analysis; Polymyositis; Polymyositis - complications; Polymyositis - epidemiology; Prevalence; Retrospective Studies; ILD; ARS; Prevalence; IL; Dermatomyositis; DM; Interstitial lung disease; IIM; Meta-analysis; MDA5; TIF1 γ; IFN-α; SRP; Polymyositis; Clinically amyopathic dermatomyositis; TNF-α; SAE; CADM; RP-ILD; HLA; MSAs; PM
• ISSN: 0049-0172; 1532-866X; 1532-866X
• DOI: 10.1016/j.semarthrit.2020.11.009

Interstitial lung disease (ILD) is the most important prognostic factor for mortality in patients with polymyositis (PM) and dermatomyositis (DM), but the prevalence of ILD in PM/DM may vary between countries. The aim of this study was to determine the overall prevalence of ILD in global patients with PM/DM. We performed a systematic literature review of studies published from Jan 1, 2000 to April 30, 2020 on ILD and PM/DM. We extracted data and pooled the prevalence by using a random-effect model due to high heterogeneity. Heterogeneity was assessed by subgroup analysis and sensitivity analysis. A total of 34 studies with 10,130 patients were included in our meta-analysis. Pooled data demonstrated that the global prevalence of ILD in patients with PM/DM was 0.41 (95% confidence interval [CI] 0.35–0.48). However, this prevalence varied with geographical locations and time trends. The prevalence of ILD in PM/DM was 0.5 (95% CI 0.42–0.57) in Asia, 0.23 (95% CI 0.15–0.31) in America, and 0.26 (95% CI 0.18–0.34) in Europe. A higher prevalence of ILD was reported in studies published in 2011–2015 (0.43, 95% CI 0.34–0.52) and 2016–2020 (0.45, 95% CI 0.35–0.54), compared with those published in 2000–2010 (0.27, 95% CI 0.16–0.39). The pooled prevalence of ILD in patients with DM, PM, and clinically amyopathic dermatomyositis subtype was 0.42 (95% CI 0.35–0.49), 0.35 (95% CI 0.27–0.42), and 0.53 (95% CI 0.32–0.74), respectively. Patients with anti-Jo-1 and anti-melanoma differentiation-associated gene 5 antibodies were more likely to develop ILD than other myositis-specific autoantibodies. The global prevalence of ILD in patients with PM/DM was approximately 41% and the condition was predominant in Asians. This highlights potential genetic and environmental differences in the pathogenesis of ILD in patients with PM/DM. More studies are required to elucidate the specific associations.