IMACS risk stratification designates DM subtype, anti-TIF1-γ positivity, anti-NXP2 positivity, age >40 years, persistent high disease activity, dysphagia, and skin necrosis/ulceration as high-risk factors, with anti-MDA5, anti-Mi-2, anti-SAE, male sex, and certain IIM subtypes designated as intermediate-risk factors [58]. This evidence concerns the gene TRIM24 and dermatomyositis.