ArticleClinical rheumatology2026
Relapse in adult idiopathic inflammatory myopathies: clinical predictors and the potential role of anti-NXP2 in a single-center retrospective cohort study.
Article in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
INTRODUCTION/
objectivesRelapse is a frequent challenge in idiopathic inflammatory myopathies (IIM); however, predictors in adults remain insufficiently defined. This study aimed to determine the relapse frequency and risk factors, with an emphasis on myositis-specific autoantibodies (MSAs), in a Turkish IIM cohort.
methodsPatients diagnosed with IIM according to established classification criteria between 2017 and 2024 at Hacettepe University Hospital, a referral center were retrospectively analyzed in a single-center cohort. Relapse was defined as a ≥ twofold increase in creatine kinase and/or escalation of immunosuppressive therapy for active muscle or extramuscular disease. Predictors were identified using logistic regression analysis.
resultsA total of 136 patients were included (66.2% female; mean age, 47.6 ± 17.5 years). The mean follow-up period was 5.3 ± 5.9 years. During this period, 46 patients (33.8%) relapsed, with a median time to relapse of 2.86 years (95% CI: 0.73-4.99). In the multivariate analysis, younger age at diagnosis (OR 0.97, 95% CI 0.95-0.99, P = 0.009), anti-NXP2 positivity (OR 5.31, 95% CI 1.24-22.58, P = 0.02), and intravenous immunoglobulin use during induction (OR 2.69, 95% CI 1.16-6.26, P = 0.02) independently predicted relapse. Maintenance immunosuppressive therapy for ≥ 5 years was associated with a significantly delayed relapse (log-rank P = 0.01).
conclusionsRelapse occurred in one-third of adult patients with IIM. Younger age, anti-NXP2 positivity, and IVIG use independently increased relapse risk, whereas long-term maintenance therapy substantially delayed relapse. These findings highlight the need for long-term immunosuppression and close monitoring of high-risk subgroups.
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