Predicting the death of patients with anti-melanoma differentiation-associated protein-5-positive dermatomyositis-associated interstitial lung disease: A systematic review and meta-analysis.

Objectives: To investigate the risk factors for death in anti-melanoma differentiation–associated protein-5-positive dermatomyositis-associated interstitial lung disease (ILD). Methods: Studies were identified by searching PubMed, Embase, Web of Science, and Cochrane Library. We calculated pooled risk ratios (RRs) or standardized mean differences (SMDs) and 95% confidence intervals (CIs) using random-effects models. Results: Twenty studies were selected. Factors that may increase death risk included older age (SMD: 0.62, 95% CI: 0.42–0.81), elevated Krebs von den Lungen-6 (SMD: 0.66, 95% CI: 0.47–0.86), lactate dehydrogenase (SMD: 0.87, 95% CI: 0.72–1.02), C-reactive protein (SMD: 0.62, 95% CI: 0.44–0.80), ferritin (SMD: 0.93, 95% CI: 0.71–1.15), creatine kinase (SMD: 0.28, 95% CI: 0.13–0.44), neutrophil (SMD: 0.34, 95% CI: 0.04–0.64), neutrophil-to-lymphocyte ratio (SMD: 0.52, 95% CI: 0.24–0.79), aspartate aminotransferase (SMD: 0.70, 95% CI: 0.45–0.94), shorter disease duration (SMD: −0.44, 95% CI: −0.67 to −0.21), rapidly progressive ILD (RR: 4.08, 95% CI: 3.01–5.54), fever (RR: 1.98, 95% CI: 1.46–2.69), dyspnoea (RR: 1.63, 95% CI: 1.32–2.02), and anti-Ro52 antibody positive (RR: 1.28, 95% CI: 1.11–1.49). Female (RR: 0.86, 95% CI: 0.78–0.94), increased albumin (SMD: −1.20, 95% CI: −1.76 to −0.64), lymphocyte (SMD: −0.49, 95% CI: −0.67 to −0.30), and arthralgia (RR: 0.53, 95% CI: 0.37–0.78) were protective factors. Conclusion: Older age, shorter disease duration, rapidly progressive ILD, fever, dyspnoea, anti-Ro52 antibody positive, and some inflammatory markers were risk factors for death in patients with anti-melanoma differentiation–associated protein-5-positive dermatomyositis-associated ILD. [ABSTRACT FROM AUTHOR]