Disease-related readmission in anti-SRP-positive immune-mediated necrotizing myopathy: Incidence and exploratory associated factors in a retrospective cohort study
- 1Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- 2Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
Abstract
Background: Anti-signal recognition particle (anti-SRP)-positive immune-mediated necrotizing myopathy (IMNM) is a severe subtype of idiopathic inflammatory myopathy, but its long-term prognosis and determinants of adverse outcomes remain insufficiently defined. Because relapse is difficult to ascertain consistently in retrospective studies, IMNM-related readmission may serve as a pragmatic outcome for evaluating subsequent disease course.
Objectives: To estimate the incidence rate of IMNM-related readmission after first discharge and to explore factors associated with readmission in patients with anti-SRP-positive IMNM.
Design: A single-center retrospective cohort study.
Methods: We included consecutively hospitalized adults with anti-SRP-positive IMNM at West China Hospital between January 2010 and June 2025. Follow-up began at first discharge. The outcome was readmission attributed to IMNM disease activity. The overall incidence rate was calculated per 100 person-years. Stratified incidence analyses were performed according to baseline variables, and factors associated with readmission were explored using LASSO-penalized Cox regression and univariable Cox regression.
Results: Among 131 included patients, 27 experienced IMNM-related readmission during follow-up. The median follow-up was 2.64 years, with a total of 398.53 person-years. The overall incidence rate of IMNM-related readmission was 6.77 per 100 person-years (95% CI, 4.46–9.86). Patients with higher De Ritis ratio (DRR, AST/ALT) had a higher readmission incidence rate than those with lower DRR [9.75 vs 3.28 per 100 person-years; incidence rate ratio (IRR) 2.98, 95% CI 1.24–7.16]. In exploratory univariable Cox regression, DRR was associated with increased readmission risk (HR 3.26, 95% CI 1.49–7.13; P = 0.003).
Conclusion: IMNM-related readmission occurred in approximately one-fifth of patients with anti-SRP-positive IMNM during follow-up. Higher DRR was associated with a higher rate of IMNM-related readmission in exploratory analyses. Further prospective studies are needed to clarify the prognostic relevance of DRR and to better characterize the long-term disease course of anti-SRP-positive IMNM.
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BibTeX
@article{cui2026diseaserelated,
title = {{Disease-related readmission in anti-SRP-positive immune-mediated necrotizing myopathy: Incidence and exploratory associated factors in a retrospective cohort study}},
author = {Beibei Cui and Hongjiang Liu and Ruiting Liu and Ziqi Li and Huijiao Chen and Geng Yin and Qibing Xie},
journal = {Therapeutic Advances in Musculoskeletal Disease},
year = {2026},
month = sep,
doi = {10.1177/1759720x261488917},
url = {https://doi.org/10.1177/1759720x261488917},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Disease-related readmission in anti-SRP-positive immune-mediated necrotizing myopathy: Incidence and exploratory associated factors in a retrospective cohort study
AU - Beibei Cui
AU - Hongjiang Liu
AU - Ruiting Liu
AU - Ziqi Li
AU - Huijiao Chen
AU - Geng Yin
AU - Qibing Xie
PY - 2026
DA - 2026/09/21
JO - Therapeutic Advances in Musculoskeletal Disease
DO - 10.1177/1759720x261488917
UR - https://doi.org/10.1177/1759720x261488917
AB - Background: Anti-signal recognition particle (anti-SRP)-positive immune-mediated necrotizing myopathy (IMNM) is a severe subtype of idiopathic inflammatory myopathy, but its long-term prognosis and determinants of adverse outcomes remain insufficiently defined. Because relapse is difficult to ascertain consistently in retrospective studies, IMNM-related readmission may serve as a pragmatic outcome for evaluating subsequent disease course. Objectives: To estimate the incidence rate of IMNM-related readmission after first discharge and to explore factors associated with readmission in patients with anti-SRP-positive IMNM. Design: A single-center retrospective cohort study. Methods: We included consecutively hospitalized adults with anti-SRP-positive IMNM at West China Hospital between January 2010 and June 2025. Follow-up began at first discharge. The outcome was readmission attributed to IMNM disease activity. The overall incidence rate was calculated per 100 person-years. Stratified incidence analyses were performed according to baseline variables, and factors associated with readmission were explored using LASSO-penalized Cox regression and univariable Cox regression. Results: Among 131 included patients, 27 experienced IMNM-related readmission during follow-up. The median follow-up was 2.64 years, with a total of 398.53 person-years. The overall incidence rate of IMNM-related readmission was 6.77 per 100 person-years (95% CI, 4.46–9.86). Patients with higher De Ritis ratio (DRR, AST/ALT) had a higher readmission incidence rate than those with lower DRR [9.75 vs 3.28 per 100 person-years; incidence rate ratio (IRR) 2.98, 95% CI 1.24–7.16]. In exploratory univariable Cox regression, DRR was associated with increased readmission risk (HR 3.26, 95% CI 1.49–7.13; P = 0.003). Conclusion: IMNM-related readmission occurred in approximately one-fifth of patients with anti-SRP-positive IMNM during follow-up. Higher DRR was associated with a higher rate of IMNM-related readmission in exploratory analyses. Further prospective studies are needed to clarify the prognostic relevance of DRR and to better characterize the long-term disease course of anti-SRP-positive IMNM.
SN - 1759-720X
SN - 1759-7218
ER -