Response to: ‘Time to personalise the treatment of anti-MDA-5 associated lung disease’ by Lake et al

We have with interest read the comments raised by Lake et al in the e-letter titled ‘Time to personalise the treatment of anti-MDA-5 associated lung disease’ to be published in your journal.1 We thank the authors for sharing their insights on the 2017 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria for adult and juvenile idiopathic inflammatory myopathies (IIM) and their major subgroups.2 Lake and colleagues are concerned that these classification criteria are not including rare specific subsets such as dermatomyositis (DM) or amyopathic DM associated with antimelanoma differentiation-associated protein 5 (MDA5). They fear that this will in turn prevent clinicians and researchers from exploring new therapeutic approaches for this population frequently affected by rapidly progressive interstitial lung disease (RPILD), a complication associated with fatal outcomes.3 4 Dr Malaviya raised a similar concern when discussing the importance of myositis-specific autoantibodies (MSA) in classifying subgroups of IIM, exemplified by …