{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T14:27:45Z","timestamp":1788532065568,"version":"build-2803163510"},"reference-count":15,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In Australia, anti\u2010MDA5 antibodies are exclusively tested by a line immunoblot assay (LIA). The clinical concordance of an LIA\u2010positive anti\u2010MDA5 result is unclear. We aimed to describe the clinical features and determine the clinical concordance of patients with anti\u2010MDA5 antibodies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Electronic records of a multisite cohort (patients with positive anti\u2010MDA5 on LIA from three states in Australia from January 2017 to September 2024) were reviewed for clinical features of dermatomyositis (cutaneous manifestations, proximal weakness, interstitial lung disease [ILD]), laboratory investigations and other myositis autoantibodies, and imaging pertaining to the muscles and lungs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Complete clinical data were available for 108 of 118 patients with anti\u2010MDA5 antibodies. A positive test was determined to be clinically concordant in 21 of 108 (19.4%) patients; these patients had higher signal intensity than those with clinical discordance (52 vs 19.5;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001). The median age was 65 years (interquartile range 48\u201374), and 67% were female. The cohort was predominantly White (n\u00a0=\u00a014), followed by Southeast Asian (n\u00a0=\u00a03), African (n\u00a0=\u00a03), and Middle Eastern (n\u00a0=\u00a01). All 21 patients with anti\u2010MDA5 dermatomyositis had ILD; 7 of 9 with rapidly progressive ILD (RP\u2010ILD) were deceased at time of review. Patients with RP\u2010ILD had higher ferritin levels (1,226 vs 262 \u03bcg\/L;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05) and a higher neutrophil to lymphocyte ratio (4.1 vs 2.6;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05) than patients without RP\u2010ILD. Pneumomediastinum developed in 7 of 21 (33%); of these, 6 had RP\u2010ILD, and 4 subsequently died. Other manifestations included myositis (n\u00a0=\u00a08), cutaneous features (n\u00a0=\u00a014), polyarthritis (n\u00a0=\u00a06), and myocarditis (n\u00a0=\u00a01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher anti\u2010MDA5 signal intensity on LIA was associated with greater clinical concordance. Pneumomediastinum is common and associated with high mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80144","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:26:16Z","timestamp":1786969576000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics and Concordance of Anti\u2010\n                    <scp>MDA5<\/scp>\n                    Antibodies: A Multicenter Australian Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4103-6953","authenticated-orcid":false,"given":"Syed B.","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Clinical Immunology and Allergy Flinders Medical Centre  Bedford Park South Australia Australia"},{"name":"School of Medicine and Public Health Flinders University  Bedford Park South Australia Australia"},{"name":"School of Medicine Adelaide University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Khoo","sequence":"additional","affiliation":[{"name":"School of Medicine Adelaide University  Adelaide South Australia Australia"},{"name":"Rheumatology Unit Royal Adelaide Hospital  Adelaide South Australia Australia"},{"name":"Rheumatology Unit Southern Adelaide Local Health Network  Bedford Park South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keeran","family":"Shivakumar","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Caroll","sequence":"additional","affiliation":[{"name":"Department of Rheumatology John Hunter Hospital  New Lambton Heights New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Hender","sequence":"additional","affiliation":[{"name":"Department of Immunopathology SA Pathology  Bedford Park South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitra","family":"Beroukas","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health Flinders University  Bedford Park South Australia Australia"},{"name":"Department of Immunopathology SA Pathology  Bedford Park South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Griggs","sequence":"additional","affiliation":[{"name":"School of Medicine Adelaide University  Adelaide South Australia Australia"},{"name":"Rheumatology Unit Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celina","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Immunopathology Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Walter and Eliza Hall Institute of Medical Research  Melbourne Victoria Australia"},{"name":"Department of Infectious Diseases The University of Melbourne  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo","family":"De Malmanche","sequence":"additional","affiliation":[{"name":"Department of Immunopathology Newcastle Laboratory  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8528-4361","authenticated-orcid":false,"given":"Jessica","family":"Day","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Walter and Eliza Hall Institute of Medical Research  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor","family":"Major","sequence":"additional","affiliation":[{"name":"Department of Rheumatology John Hunter Hospital  New Lambton Heights New South Wales Australia"},{"name":"Faculty of Medicine University of Newcastle  Callaghan New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidya","family":"Limaye","sequence":"additional","affiliation":[{"name":"School of Medicine Adelaide University  Adelaide South Australia Australia"},{"name":"Rheumatology Unit Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resinv.2016.08.007"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keae167"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-012-0663-4"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.773352"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40320"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11061"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtauto.2019.100013"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2025.152858"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21023"},{"issue":"2","key":"e_1_2_7_11_1","first-page":"193","article-title":"Different phenotypic manifestations between Brazilian and Japanese anti\u2010MDA5 antibody\u2010positive dermatomyositis: an international tricentric longitudinal study","volume":"43","author":"Faria MSMS","year":"2025","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-025-03512-4"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead638"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2023.152352"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2023.152231"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-023-03100-z"}],"container-title":["Arthritis Care &amp; 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