Anti-Ro-52 antibody is a risk factor for recurrence in interstitial lung disease with positive anti-aminoacyl tRNA synthetase antibody: A single-center, retrospective observational study

Purpose Anti-synthetic syndrome-associated interstitial lung disease (ASS-ILD) recurs in approximately 56% of cases, with recurrence associated with poor long-term prognosis; however, there are few reports on the risk factors for recurrence. While anti-Ro52 antibodies are considered risk factors for rapidly progressing interstitial lung disease in ASS, their role in ASS-ILD recurrence remains unclear. ༷e aimed to evaluate the association between anti-Ro52 antibody and the recurrence of ASS-ILD. Methods This single-center, retrospective cohort study included 97 patients diagnosed with ASS-ILD between January 2010 and August 2023 who underwent induction remission therapy with corticosteroids and immunosuppressive agents (tacrolimus, cyclosporine, and cyclophosphamide). Patients were classified into anti-Ro52 antibody-positive and anti-Ro52 antibody-negative groups. A competing risk analysis was conducted, with the primary endpoint being ASS-ILD recurrence or interstitial pneumonia (IP)-related death and death from other causes as the competing risk. Multivariate analysis identified recurrence factors. Results Forty-four patients were in the anti-Ro52 antibody-positive group and 53 in the anti-Ro52 antibody-negative group. There were no differences between the groups regarding initial and recurrence steroid doses, type of immunosuppressive drugs, and number of discontinued cases. The anti-Ro52 antibody-positive group had a significantly higher rate of recurrent ASS-ILD or ILD-related death in a competing risk analysis ( P  = 0.011). In multivariate analysis, the anti-Ro52 antibody was identified as an independent risk factor for ASS-ILD recurrence (hazard ratio = 1.84 [1.01–3.36], P  = 0.047). Conclusion Anti-Ro52 antibodies are a risk factor for ASS-ILD recurrence.