Characterizing Race Based Differences in Antisynthetase Syndrome

Background Antisynthetase syndrome-associated interstitial lung disease (ASyS-ILD) is a rare autoimmune condition characterized by antisynthetase antibodies and progressive lung involvement. Limited research has explored racial differences in the clinical presentation and outcomes of ASyS-ILD. This study compared clinical manifestations, pulmonary function, and outcomes between Black and White patients with ASyS-ILD. Methods A retrospective analysis was conducted using electronic health records from 2010–2020. Patients diagnosed with ILD and positive antisynthetase antibodies were included (N = 66; 34 Black, 32 White). Demographics, comorbidities, clinical features, pulmonary function tests, chest imaging, and clinical outcomes were compared between races. Results Black patients were younger at diagnosis (49.1 ± 10.8 vs. 55.1 ± 12.9 years, p = 0.043) and had reduced pulmonary function (p < 0.01). Black patients also had a higher prevalence of traction bronchiectasis (96.6% vs. 73.1%, p = 0.012) and obstructive sleep apnea (p = 0.025). There were no differences in the frequency of hospitalizations, intensive care unit admissions, or deaths between groups. Myositis was common in both groups, and the distribution of antisynthetase antibodies did not differ by race (p = 0.333). Conclusions Black patients are younger at diagnosis, have reduced lung function, and increased traction bronchiectasis compared to White patients with ASyS. There is a higher prevalence of obstructive sleep apnea amongst Black patients without differences in body mass index. There was no difference in mortality and the need for lung transplant. This highlights important differences among Black and White patients with ASyS. Future prospective studies using larger patient cohorts would validate these findings and help understand the impact of race on long-term outcomes in ASyS patients.