{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:31:19Z","timestamp":1792629079965,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T00:00:00Z","timestamp":1734393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["ZIA ES101081"],"award-info":[{"award-number":["ZIA ES101081"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008741","name":"European League Against Rheumatism","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008741","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000960","name":"American College of Rheumatology Research and Education Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000960","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Anti\u2010synthetase syndrome (ASSD) is a rare systemic autoimmune rheumatic disease (SARD) with significant heterogeneity and no shared classification criteria. We aimed to identify clinical and serological features associated with ASSD that may be suitable for inclusion in the data\u2010driven classification criteria for ASSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used a large, international, multicenter \u201cClassification Criteria for Anti\u2010synthetase Syndrome\u201d (CLASS) project database, which includes both patients with ASSD and controls with mimicking conditions, namely, SARDs and\/or interstitial lung disease (ILD). The local diagnoses of ASSD and controls were confirmed by project team members. We employed univariable logistic regression and multivariable Ridge regression to evaluate clinical and serological features associated with an ASSD diagnosis in a randomly selected subset of the cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our analysis included 948 patients with ASSD and 1,077 controls. Joint, muscle, lung, skin, and cardiac involvement were more prevalent in patients with ASSD than in controls. Specific variables associated with ASSD included arthritis, diffuse myalgia, muscle weakness, muscle enzyme elevation, ILD, mechanic's hands, secondary pulmonary hypertension due to ILD, Raynaud phenomenon, and unexplained fever. In terms of serological variables, Jo\u20101 and non\u2013Jo\u20101 anti\u2010synthetase autoantibodies, antinuclear antibodies with cytoplasmic pattern, and anti\u2010Ro52 autoantibodies were associated with ASSD. In contrast, isolated arthralgia, dysphagia, electromyography\/magnetic resonance imaging\/muscle biopsy findings suggestive of myopathy, inflammatory rashes, myocarditis, and pulmonary arterial hypertension did not differentiate between patients with ASSD and controls or were inversely associated with ASSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We identified key clinical and serological variables associated with ASSD, which will help clinicians and offer insights into the development of data\u2010driven classification criteria for ASSD.<\/jats:p><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/art43038-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1002\/art.43038","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T14:18:54Z","timestamp":1730125134000},"page":"477-489","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Clinical Characteristics of Anti\u2010Synthetase Syndrome: Analysis From the Classification Criteria for Anti\u2010Synthetase Syndrome Project"],"prefix":"10.1002","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5948-0297","authenticated-orcid":false,"given":"Sara","family":"Faghihi\u2010Kashani","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3590-1637","authenticated-orcid":false,"given":"Akira","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Nippon Medical School Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2711-0434","authenticated-orcid":false,"given":"Francisca","family":"Bozan","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universidad de Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5042-1282","authenticated-orcid":false,"given":"Giovanni","family":"Zanframundo","sequence":"additional","affiliation":[{"name":"Universit\u00e0 di Pavia and Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2648-742X","authenticated-orcid":false,"given":"Davide","family":"Rozza","sequence":"additional","affiliation":[{"name":"Italian Society of Rheumatology  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3576-7204","authenticated-orcid":false,"given":"Aravinthan","family":"Loganathan","sequence":"additional","affiliation":[{"name":"Royal National Hospital for Rheumatic Diseases and University of Bath, Bath, UK, and Arthritis Australia  Broadway Glebe New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2186-2833","authenticated-orcid":false,"given":"Eduardo","family":"Dourado","sequence":"additional","affiliation":[{"name":"Centro Hospitalar do Baixo Vouga and Egas Moniz Health Alliance, Aveiro, and Faculdade de Medicina, Universidade de Lisboa  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9933-1202","authenticated-orcid":false,"given":"Gianluca","family":"Sambataro","sequence":"additional","affiliation":[{"name":"Policlinico G. 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