On the other hand, anti-MDA5 positive DM patients with disease onset in colder months (October to March) were less likely to have clinically significant weakness (spring: 49%, summer: 47%, autumn: 31%, winter: 13%, p = 0.013) and hoarseness (spring: 20%, summer: 40%, autumn: 0%, winter: 10%, p = 0.003). This evidence concerns the gene IFIH1 and dermatomyositis.