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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe presence of myositis-associated autoantibodies is the strongest predictor of improvement in patients with adult and juvenile myositis treated with B-cell depletion. This article describes findings from the Rituximab for the Treatment of Refractory Adult and Juvenile Dermatomyositis and Adult Polymyositis [RIM] study, in which baseline clinical, laboratory, and serologic predictors of response were examined in rituximab-treated patients with refractory myositis, defined as failure of steroids and at least 1 other immunosuppressive agent.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ERheumatological Autoimmune Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInflammatory Disorders Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThe presence of myositis-associated autoantibodies is the strongest predictor of improvement in patients with adult and juvenile myositis treated with B-cell depletion.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ERohit Aggarwal, MD, MS, University of Pittsburgh, Pittsburgh, Pennsylvania, USA, described findings from the Rituximab for the Treatment of Refractory Adult and Juvenile Dermatomyositis (DM) and Adult Polymyositis (PM) [RIM] study, in which baseline clinical, laboratory, and serologic predictors of response were examined in rituximab-treated patients with refractory myositis, defined as failure of steroids and at least 1 other immunosuppressive agent. The study included 200 patients (76 with adult PM, 76 with adult DM, and 48 with juvenile DM) who were randomized to early (Weeks 0 and 1) or late (Weeks 8 or 9) rituximab with follow-up to 44 weeks.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe definition of improvement [Rider LG et al. \u003Cem\u003EArthritis Rheum\u003C\/em\u003E 2004] for this study is defined as improvement in 3 of any 6 core set measures (CSM) by \u226520%, with no more than 2 CSM worsening by \u226525% (excluding manual muscle testing) at 2 consecutive visits. The primary endpoint was to compare the time to improvement between the rituximab early and rituximab late groups. As reported previously [Oddis CV et al. \u003Cem\u003EArthritis Rheum\u003C\/em\u003E 2012], 83% of patients improved during the course of trial, with no difference in response between the 2 treatment groups.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EFor the current study, a list of the candidates\u0027 baseline clinical and laboratory parameters was compiled as potential predictor variables. All baseline variables were univariately assessed for association with time to improvement. All univariate variables that predicted or trended toward an association with time to improvement were then entered into a multivariate model. A final multivariate time-dependent Cox model was then created.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe final multivariate model consisted of global damage (high vs low) at Week 8 (p\u0026lt;0.01), disease subset (adult vs juvenile) at Week 8 (p\u0026lt;0.01), and myositis autoantibodies: Jo-1\/other anti-syn (p\u0026lt;0.01) and Mi-2 (p\u0026lt;0.01) compared with no autoantibodies group. However, both global damage and disease subset washed out as significant predictive variables by Week 20, leaving anti-Jo-1 and anti-Mi-2 as the only significant markers of good prognosis and predictor of treatment response throughout the study.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EIn summary, the presence of juvenile DM and low global damage predicted a more rapid response than did adult onset myositis and high global damage, respectively. Although low global damage and juvenile DM were associated with more rapid improvement, there was no evidence that either predicts better prognosis if patients fail to improve early, said Dr. Aggarwal. The strongest predictor of improvement was the presence of myositis autoantibodies anti-Jo-1 and anti-Mi-2, which remained significant throughout the study period. In the future, myositis autoantibodies may serve as a prognostic marker and further investigation is needed for evaluation of anti-Jo-1 levels as a biomarker for myositis disease activity.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2012 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/12\/19\/14.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzn5e2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}