Anti-MDA5 dermatomyositis: an update from bench to bedside

Curr Opin Rheumatol. 2022 Nov 1;34(6):365-373. doi: 10.1097/BOR.0000000000000908. Epub 2022 Sep 12.

Abstract

Purpose of review: This review summarizes the recent developments about anti-MDA5 antibody positive dermatomyositis with a focus on its pathogenesis, clinical features and treatment options of rapidly progressive interstitial lung disease, its most ominous complication.

Recent findings: Anti-MDA5+ dermatomyositis has a heterogeneous clinical spectrum with different patient subsets exhibiting widely different outcomes; severe acute interstitial lung disease is the main factor impacting prognosis. The pathogenetic role of anti-MDA5 antibodies is an active area of investigation.

Summary: Anti-MDA5+ dermatomyositis has a wider spectrum of manifestations than previously thought. A high index of suspicion is needed not to miss atypical presentations. In the setting of acute interstitial lung involvement, once a confident diagnosis is made, an aggressive approach with early combined immunosuppression affords the best chances of survival.

Publication types

  • Review

MeSH terms

  • Autoantibodies
  • Dermatomyositis* / diagnosis
  • Dermatomyositis* / therapy
  • Humans
  • Interferon-Induced Helicase, IFIH1
  • Lung Diseases, Interstitial* / diagnosis
  • Lung Diseases, Interstitial* / etiology
  • Lung Diseases, Interstitial* / therapy
  • Prognosis

Substances

  • Autoantibodies
  • Interferon-Induced Helicase, IFIH1