Background Idiopathic inflammatory myopathies (IIMs) are frequently complicated by interstitial lung disease (ILD). The independent clinical significance of myositis autoantibody positivity remains incompletely defined.Methods We performed a retrospective cohort study of patients undergoing myositis autoantibody testing at a single tertiary center (1997–2022). Multivariable logistic regression assessed the association between antibody positivity and ILD. Subgroup analyses evaluated clinical phenotypes and radiologic patterns.Results Among 1,034 patients included in the analysis, 359 (34.7%) were positive for at least one myositis autoantibody and 365 (35.5%) had ILD. Antibody-positive patients were younger, more frequently female, and had a higher prevalence of ILD compared to antibody-negative patients (41.2% vs 32.2%, p < 0.01).Myositis antibody positivity was independently associated with ILD (adjusted OR 1.78, 95% CI 1.33–2.37, p < 0.001). Increasing age, higher BMI, former smoking status, and Asian ethnicity were also associated with ILD. Among patients with ILD, antibody-positive individuals had a higher prevalence of systemic autoimmune features, including Raynaud’s phenomenon, arthritis, and mechanic’s hands, as well as higher inflammatory markers and more impaired pulmonary function.Conclusion Myositis autoantibody positivity is independently associated with ILD and identifies a distinct clinical phenotype. These findings should be interpreted in the context of the study’s retrospective, single-center design.
Alrehaili et al. (Thu,) studied this question.