{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:54:05Z","timestamp":1789952045468,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,2,24]],"date-time":"2016-02-24T00:00:00Z","timestamp":1456272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Intramural Research Program of the National Institute of Environmental Health Sciences, NIH"},{"name":"Cure JM Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify early factors associated with disease course in patients with juvenile idiopathic inflammatory myopathies (IIMs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Univariable and multivariable multinomial logistic regression analyses were performed in a large juvenile IIM registry (n\u2009=\u2009365) and included demographic characteristics, early clinical features, serum muscle enzyme levels, myositis autoantibodies, environmental exposures, and immunogenetic polymorphisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multivariable associations with chronic or polycyclic courses compared to a monocyclic course included myositis\u2010specific autoantibodies (multinomial odds ratio [OR] 4.2 and 2.8, respectively), myositis\u2010associated autoantibodies (multinomial OR 4.8 and 3.5), and a documented infection within 6 months of illness onset (multinomial OR 2.5 and 4.7). A higher overall clinical symptom score at diagnosis was associated with chronic or monocyclic courses compared to a polycyclic course. Furthermore, severe illness onset was associated with a chronic course compared to monocyclic or polycyclic courses (multinomial OR 2.1 and 2.6, respectively), while anti\u2010p155\/140 autoantibodies were associated with chronic or polycyclic courses compared to a monocyclic course (multinomial OR 3.9 and 2.3, respectively). Additional univariable associations of a chronic course compared to a monocyclic course included photosensitivity, V\u2010sign or shawl sign rashes, and cuticular overgrowth (OR 2.2\u20133.2). The mean ultraviolet index and highest ultraviolet index in the month before diagnosis were associated with a chronic course compared to a polycyclic course in boys (OR 1.5 and 1.3), while residing in the Northwest was less frequently associated with a chronic course (OR 0.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings indicate that myositis autoantibodies, in particular anti\u2010p155\/140, and a number of early clinical features and environmental exposures are associated with a chronic course in patients with juvenile IIM. These findings suggest that early factors, which are associated with poorer outcomes in juvenile IIM, can be identified.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.39466","type":"journal-article","created":{"date-parts":[[2015,10,16]],"date-time":"2015-10-16T16:03:56Z","timestamp":1445011436000},"page":"761-768","source":"Crossref","is-referenced-by-count":51,"title":["Brief Report: Association of Myositis Autoantibodies, Clinical Features, and Environmental Exposures at Illness Onset With Disease Course in Juvenile Myositis"],"prefix":"10.1002","volume":"68","author":[{"given":"G. Esther A.","family":"Habers","sequence":"first","affiliation":[{"name":"University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam M.","family":"Huber","sequence":"additional","affiliation":[{"name":"IWK Health Center and Dalhousie University Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulnara","family":"Mamyrova","sequence":"additional","affiliation":[{"name":"George Washington University School of Medicine Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ira N.","family":"Targoff","sequence":"additional","affiliation":[{"name":"VAMC, University of Oklahoma Health Sciences Center, and Oklahoma Medical Research Foundation Oklahoma City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrance P.","family":"O'Hanlon","sequence":"additional","affiliation":[{"name":"National Institute of Environmental Health Sciences, NIH 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