{
  "abstract": "Background\n\nAnti-melanoma differentiation-associated gene 5-positive dermatomyositis (anti-MDA5+ DM) is a severe subtype frequently complicated by rapidly progressive interstitial lung disease (RP-ILD), leading to high early mortality. However, factors associated with long-term survival beyond 10 years remain largely uncharacterized. This exploratory analysis aimed to identify baseline factors associated with long-term all-cause mortality in a 10-year follow-up cohort using LASSO-Cox regression.Methods\n\nThis retrospective longitudinal study enrolled 84 inpatients diagnosed with anti-MDA5+ DM between 2010 and June 2014; surviving patients had more than 10 years of potential follow-up until March 2026. The primary endpoint was all-cause mortality. All candidate covariates, including clinical features, laboratory parameters, HRCT score, and initial treatment variables, were entered simultaneously into LASSO-penalized Cox regression with 10-fold cross-validation, and retained variables were directly entered into a multivariable Cox model. The proportional hazards assumption was tested, and bootstrap resampling was performed to assess selection stability. Survival was illustrated using Kaplan-Meier curves with log-rank tests.Results\n\nAmong the 84 patients (27 males and 57 females), 41 (48.8%) were alive at the final follow-up and 43 (51.2%) had died. As a descriptive observation, 25 surviving patients (29.8% of the total cohort) had maintained sustained drug-free remission for over 2 years. Four baseline factors were independently associated with long-term mortality. Older age (HR = 1.05 per 1-year increase, P < 0.001), fever on admission (HR = 2.08, P = 0.036), and higher HRCT score (HR = 1.94 per 1-point increase, P < 0.001) were associated with higher mortality, whereas concurrent arthritis was associated with lower mortality (HR = 0.45, P = 0.022). Male sex showed a trend toward higher mortality that was not statistically significant after adjustment (P = 0.086).Conclusion\n\nOlder age, admission fever, higher HRCT score, and absence of arthritis - all assessable at admission - were independently associated with all-cause mortality over long-term follow-up in the full anti-MDA5+ DM cohort; landmark analysis showed only arthritis and HRCT score remained associated with mortality after year 1. Given the limited sample size and lack of external validation, these exploratory findings are hypothesis-generating and require confirmation in independent multicenter cohorts.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Rheumatology and Immunology, The Second People's Hospital of Changzhou, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, China.",
    "Department of Rheumatology & Immunology, Arthritis Clinical Diagnosis and Treatment Centre, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.",
    "Department of Rheumatology and Immunology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.",
    "Department of Respiratory and Critical Care Medicine, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yan Wang"
    },
    {
      "affs": [
        1
      ],
      "name": "Xueliang Zhang"
    },
    {
      "affs": [
        2
      ],
      "name": "Xiaolei Ma"
    },
    {
      "affs": [
        2
      ],
      "name": "Xin Zhang"
    },
    {
      "affs": [
        1
      ],
      "name": "Sheng-Ming Dai"
    },
    {
      "affs": [
        3
      ],
      "name": "Yin Liu"
    },
    {
      "affs": [
        2
      ],
      "name": "Shengnan Zhao"
    },
    {
      "affs": [
        1
      ],
      "name": "Zhiyong Chen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5k6b4jna1cn2x.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1908926",
  "fulltext_url": "https://europepmc.org/articles/PMC13688878",
  "id": "5k6b4jna1cn2x",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42923589",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Inflammatory Myopathies and Dermatomyositis"
    ]
  ],
  "openalex": "W7220999840",
  "pdf_url": "https://europepmc.org/articles/PMC13688878?pdf=render",
  "pmcid": "PMC13688878",
  "pmid": "42923589",
  "published": "2026-10-08",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5k6b4jna1cn2x.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:33Z",
      "native_id": "MED:42923589",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42923589"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Inflammatory Myopathies and Dermatomyositis",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Prognostic factors for long-term survival in anti-MDA5-positive dermatomyositis: a 10-year cohort study.",
  "title_text": "Prognostic factors for long-term survival in anti-MDA5-positive dermatomyositis: a 10-year cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:33Z",
  "url": "https://research.draconitic.com/paper/5k6b4jna1cn2x",
  "venue": "Frontiers in medicine",
  "versions": []
}