There remains a significant need for an accurate, predictive test for likely progression to autoimmunity in this patient population, says Md Yuzaiful Md Yusof, MBChB, MRCP, a rheumatologist and doctoral research fellow at the University of Leeds, and one of the study’s co-authors. The researchers’ primary goal was to find a reliable test to stratify patients at highest risk for progression and allow for early treatment to help prevent irreversible tissue damage, and reduce the need for remission induction therapy with glucocorticoids. AI-CTDs include such diseases as systemic lupus erythematosus, primary Sjögren’s syndrome, systemic sclerosis (SSc), inflammatory myopathies and mixed and undifferentiated CTDs.
“ANA positivity, as detected from a blood test, is a common finding. However, only less than 1% of individuals with a positive test progress into autoimmune connective tissue disease,” says Dr. Yusof. Because there are “limited data on reliable predictors of progression, some of these individuals may be discharged prematurely after the first consultation if they do not meet the criteria of an AI-CTD. Although it may not be cost effective to follow up all these individuals routinely in clinic, the risk of premature discharge from secondary care can lead to a delay in diagnosis, and, should they progress, this can result in damage accrual and development of comorbidities.”
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‘By screening ANA-positive individuals for the two predictors of progression identified in our study—IFN scores & a positive family history of autoimmune rheumatic diseases—those with the imminent risk of relapse can be offered early treatment to prevent severe organ involvement, organ damage & glucocorticoid use.’ —Dr. Yusof