ArticleClinical rheumatology2026
The clinical values of laboratory inflammatory and composite indices in predicting rapidly progressive interstitial lung disease and prognosis in anti-MDA5 dermatomyositis patients.
Article in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- The Role of Ultrasound Pleural Irregularities in the Identification of Interstitial Lung Disease in Idiopathic Inflammatory Myopathies.Journal of personalized medicine · 2026Article
- Linear association between the systemic immune-inflammation index and all-cause mortality in patients with interstitial lung disease: a retrospective cohort study.Frontiers in medicine · 2026Article
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8 authors.
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Abstract
objectivesRapidly progressive interstitial lung disease (RPILD) is the most severe complication of anti-melanoma differentiation-associated gene 5-positive dermatomyositis (anti-MDA5-DM) and is relevant to poor prognosis. This retrospective study aimed to identify the clinical value of laboratory inflammatory and composite indices in patients with anti-MDA5-DM and determine their role in predicting the incidence of RPILD and disease prognosis.
methodsIn total, 51 patients with anti-MDA5-DM were retrospectively enrolled from July 2018 to April 2025. Patients were categorized into RPILD and non-RPILD subgroups (including those with stable ILD and without ILD), as well as survival and non-survival cohorts. Clinical and laboratory information was collected, and laboratory inflammatory and composite indices were calculated.
resultsIn the RPILD group, levels of laboratory inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), pan-immune-inflammation value (PIV), systemic inflammation response index (SIRI), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), were higher than in the non-RPILD group, while lymphocyte-to-monocyte ratio (LMR) was lower (both P < 0.05). Composite indices such as albumin-to-alkaline phosphatase ratio (AAPR) and prognostic nutritional index (PNI) were lower in the RPILD group (both P < 0.05). The receiver operating characteristic (ROC) analysis demonstrated that a combination of SII, NLR, PIV, SIRI, and LMR yielded the highest predictive power for RPILD occurrence, with an area under the curve (AUC) of 77.21% (95% CI 0.6437-0.9009). For mortality prediction, LMR alone showed the best performance (AUC 73.93%, 95% CI 0.5876-0.8909). Spearman's correlation analysis indicated that NLR exhibited a strong positive correlation with RPILD occurrence (r = 0.4343, 95% CI = 0.1722 to 0.6390) and all-cause mortality (r = - 0.3839, 95% CI = - 0.6011 to - 0.1119). Kaplan-Meier survival analysis further confirmed that elevated SII, PIV, and inflammatory burden index (IBI), as well as decreased LMR, hemoglobin, albumin, lymphocyte, platelet score (HALP), and AAPR, were significantly associated with poorer overall survival (all P < 0.05). To facilitate clinical translation, a nomogram predictive model was developed incorporating NLR and SIRI, which effectively estimated the probability of RPILD occurrence.
conclusionReadily available laboratory inflammatory and composite indices serve as practical and cost-effective biomarkers for predicting the incidence of RPILD and mortality in patients with anti-MDA5-DM. Key Points • Systematic evaluation of laboratory inflammatory and composite indices confirmed their significant association with disease severity in anti-MDA5-DM. • A novel nomogram integrating the neutrophil-to-lymphocyte ratio (NLR) and systemic inflammation response index (SIRI) effectively predicted the risk of rapidly progressive interstitial lung disease (RPILD), demonstrating good calibration and clinical utility.
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