Timing of onset affects arthritis presentation pattern in antisyntethase syndrome

Miguel A González-Gay, Carlomaurizio Montecucco, Albert Selva-O'Callaghan, Ernesto Trallero-Araguas, Ovynd Molberg, Helena Andersson, Jorge Rojas-Serrano, Diana Isabel Perez-Roman, Jutta Bauhammer, Christoph Fiehn, Rossella Neri, Simone Barsotti, Hannes M Lorenz, Andrea Doria, Anna Ghirardello, Florenzo Iannone, Margherita Giannini, Franco Franceschini, Ilaria Cavazzana, Konstantinos TriantafylliasMaurizio Benucci, Maria Infantino, Mariangela Manfredi, Fabrizio Conti, Andreas Schwarting, Giandomenico Sebastiani, Annamaria Iuliano, Giacomo Emmi, Elena Silvestri, Marcello Govoni, Carlo Alberto Scirè, Federica Furini, Francisco Javier Lopez-Longo, Julia Martínez-Barrio, Marco Sebastiani, Andreina Manfredi, Javier Bachiller-Corral, Walter Alberto Sifuentes Giraldo, Marco A Cimmino, Claudio Cosso, Alessandro Belotti Masserini, Giovanni Cagnotto, Veronica Codullo, Mariaeva Romano, Carlo Selmi, Federica Meloni, Enrico Marchioni, Nicolò Pipitone, Claudia Alpini, Lorenzo Cavagna, AENEAS (American and European NEtwork of Antisynthetase Syndrome) collaborative group.

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: To evaluate if the timing of appearance with respect to disease onset may influence the arthritis presentation pattern in antisynthetase syndrome (ASSD).

METHODS: The patients were selected from a retrospective large international cohort of ASSD patients regularly followed-up in centres referring to AENEAS collaborative group. Patients were eligible if they had an antisynthetase antibody testing positive in at least two determinations along with arthritis occurring either at ASSD onset (Group 1) or during the course of the disease (Group 2).

RESULTS: 445 (70%; 334 females, 110 males, 1 transsexual) out of the 636 ASSD we collected had arthritis, in the majority of cases (367, 83%) from disease onset (Group 1). Patients belonging to Group 1 with respect to Group 2 had an arthritis more commonly polyarticular and symmetrical (p=0.015), IgM-Rheumatoid factor positive (p=0.035), erosions at hands and feet plain x-rays (p=0.036) and more commonly satisfying the 1987 revised classification criteria for rheumatoid arthritis (RA) (p=0.004). Features such as Raynaud's phenomenon, mechanic's hands and fever (e.g. accompanying findings) were more frequently reported in Group 2 (p=0.005).

CONCLUSIONS: In ASSD, the timing of appearance with respect to disease onset influences arthritis characteristics. In particular, RA features are more common when arthritis occurs from ASSD onset, suggesting an overlap between RA and ASSD in these patients. When arthritis appears during the follow-up, it is very close to a connective tissue disease-related arthritis. Also, the different prevalence of accompanying features between these two groups is in line with this possibility.

Original languageEnglish
Pages (from-to)44-49
Number of pages6
JournalClinical and Experimental Rheumatology
Issue number1
Publication statusPublished - Aug 5 2017


  • Journal Article

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