Anti-Ro-52 antibody is a risk factor for recurrence in interstitial lung disease with positive anti-aminoacyl tRNA synthetase antibody: a single-center, retrospective observational study

BACKGROUND: Anti-synthetase syndrome-associated interstitial lung disease (ASyS-ILD) frequently recurs, and its recurrence is associated with poor long-term outcomes. Although anti-Ro52 antibodies have been linked to rapidly progressing ILD, their role in ASyS-ILD recurrence remains unclear. This study aimed to investigate the association between anti-Ro52 antibody positivity and ASyS-ILD recurrence. METHODS: This single-center retrospective study included 96 patients with ASyS-ILD who received induction therapy with corticosteroids and immunosuppressants between January 2010 and August 2023. Patients were classified by anti-Ro52 antibody status. The primary analysis was performed using a Fine and Gray competing risks model to assess recurrence or ILD-related death, with non-ILD-related death as a competing event. We performed a multivariable competing risks regression analysis using the Fine-Gray sub-distribution hazards model to evaluate the effect of variables on the cumulative incidence of the main outcome. RESULTS: Forty-four patients were anti-Ro52 positive, and 52 were negative. There were no significant differences in initial treatment regimens. The anti-Ro52 group had a significantly higher incidence of recurrence or ILD-related death in the Fine and Gray model (HR: 2.11, 95% CI: 1.21-3.69, P = 0.008). Multivariable competing risks regression analysis also identified anti-Ro52 positivity as a risk factor for recurrence (HR: 1.77, 95% CI: 1.00-3.11, P = 0.049). CONCLUSIONS: Anti-Ro52 antibody positivity is associated with increased risk of recurrence in ASyS-ILD. These findings suggest that anti-Ro52 status may serve as a useful biomarker to identify patients who require close monitoring and long-term management.