Key result
Anti-SRP NAM links to worse cardiopulmonary involvement and 12-month disability than anti-HMGCR.
Why the study?
Necrotizing autoimmune myopathy is classified into three subtypes based on antibodies, but data from Southeast Asian populations remain limited.
Cohort (n=29)
No
Anti-SRP-associated necrotizing autoimmune myopathy presents with more severe clinical features, including cardiac involvement, and worse 12-month functional recovery compared to anti-HMGCR-associated disease.
May support closer cardiac monitoring in anti-SRP NAM; leaves open whether antibody subtype should guide therapy intensity.
Background: Necrotizing autoimmune myopathy (NAM) is classified into 3 subtypes according to antibodies. Data from Southeast Asian populations remain limited. Objective: To describe and compare clinical characteristics and treatment responses among the NAM subtypes. Methods: Retrospective cohort included three subtypes of 29 patients with NAM. Demographics, clinical data, treatment approach, and responses were assessed and compared. Results: There were 20 (68.97%) anti–signal recognition particle (SRP), 8 anti–hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) (27.59%), and 1 (3.44%) seronegative patients. Anti-SRP, compared with anti-HMGCR patients, tended to be more severe with cardiac and respiratory involvement. They tended to have residual disabilities at 12 months, whereas most anti-HMGCR patients achieved near-complete functional recovery. Associated cancer was found in an anti-HMGCR–associated patient. Rituximab administration in patients who did not respond to first-line therapy resulted in clinical improvement. Conclusions: Patients with anti-SRP–associated NAM were relatively more severe. Cancer screening should be considered in anti-HMGCR patients. Rituximab was beneficial in individual patients.
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Angsuwattanakul et al. (2026) conducted a cohort in Necrotizing autoimmune myopathy (NAM) (n=29). Anti-SRP subtype vs. Anti-HMGCR subtype was evaluated on Clinical characteristics and treatment responses. Anti-SRP-associated necrotizing autoimmune myopathy (68.97% of cases) was associated with more severe cardiac and respiratory involvement and residual disabilities at 12 months compared to anti-HMGCR.
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