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HIGH FATIGUE SCORES IN PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES : A MULTIGROUP COMPARATIVE STUDY FROM THE COVAD E-SURVEY

Grignaschi, S. (author)
Fondazione I.R.C.C.S. Policlinico San Matteo, Rheumatology, Pavia, Italy; The University of Pavia, Department of Internal Medicine and Medical Therapeutics, Pavia, Italy
Cavagna, L. (author)
Fondazione I.R.C.C.S. Policlinico San Matteo, Rheumatology, Pavia, Italy; The University of Pavia, Department of Internal Medicine and Medical Therapeutics, Pavia, Italy
Kim, M. (author)
University of Illinois College of Medicine at Peoria, Department of Internal Medicine, Peoria, United States of America
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R, N. (author)
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Clinical Immunology and Rheumatology, Lucknow, India
Lilleker, J. B. (author)
School of Biological Sciences University of Manchester, Division of Musculoskeletal and Dermatological Sciences, Rochester, United Kingdom; Manchester Centre for Clinical Neurosciences, Clinical Neurosciences, Salford, United Kingdom
Sen, P. (author)
Maulana Azad Medical College (MAMC), Rheumatology, New Delhi, India
Agarwal, V. (author)
Mahatma Gandhi Mission Medical College, Navi Mumbai, India
Kardes, S. (author)
Istanbul University Faculty of Medicine, Department of Medical Ecology and Hydroclimatology, Istanbul, Turkey
Day, J. (author)
Royal Melbourne Hospital Neuroscience Foundation, Department of Rheumatology, Parkville, Australia; WEHI - Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; University of Melbourne, Department of Medical Biology, Parkville, Australia
Makol, A. (author)
Mayo Clinic, Division of Rheumatology, Rochester, United States of America
Milchert, M. (author)
Pomeranian Medical University, Department of Rheumatology, Internal Medicine, Geriatrics and Clinical Immunology, Szczecin, Poland
Gheita, T. A. (author)
Faculty Of Medicine Kasr Al-Ainy Cairo University, Rheumatology Department, Cairo, Egypt
Salim, B. (author)
Fauji Foundation Hospital Road, Rheumatology Department, Rawalpindi, Pakistan
Velikova, T. (author)
Lozenetz University Hospital, Department of Clinical Immunology, Sofia, Bulgaria
Gracia-Ramos, A. E. (author)
IMSS, Department of Internal Medicine, Ciudad de México, Mexico
Parodis, Ioannis, 1981- (author)
Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Karolinska University Hospital, Division of Rheumatology, Stockholm, Sweden; Örebro University, Department of Rheumatology, Örebro, Sweden
Selva-O'callaghan, A. (author)
La Vall d’Hebron, Systemic Autoimmune Diseases Unit, Internal Medicine Department, Barcelona, Spain
Nikiphorou, E. (author)
King’s College London, Centre for Rheumatic Diseases, London, United Kingdom; King’s College Hospital, Dept of Rheumatology, London, United Kingdom
Chatterjee, T. (author)
University of Illinois College of Medicine at Peoria, Department of Internal Medicine, Peoria, United States of America
Tan, A. L. (author)
Leeds General Infirmary, NIHR Leeds Biomedical Research Centre, Leeds, United Kingdom; University of Leeds, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, United Kingdom
Saavedra, M. A. (author)
Centro Medico Nacional La Raza, Departamento de Reumatología, Ciudad de México, Mexico
Shinjo, S. Katsuyuki (author)
Faculdade de Medicina da Universidade de São Paulo, Division of Rheumatology, Sao Paulo, Brazil
Ziade, N. (author)
Saint Joseph University of Beirut, Rheumatology Department, Bayrut, Lebanon; Hôtel-Dieu de France, Rheumatology Department, Bayrut, Lebanon
Knitza, J. (author)
University of Erlangen-Nuremberg, Medizinische Klinik 3 - Rheumatologie und Immunologie, Erlangen, Germany
Kuwana, M. (author)
Nippon Medical School, Department of Allergy and Rheumatology, Bunkyo City, Japan
Nune, A. (author)
Southport & Ormskirk Hospital NHS Trust, Southport, United Kingdom
Distler, O. (author)
University Hospital of Zürich, Rheumatology, Zürich, Switzerland
Chinoy, H. (author)
School of Biological Sciences University of Manchester, Division of Musculoskeletal and Dermatological Sciences, Manchester, United Kingdom; NIHR Manchester Biomedical Research Unit, Manchester, United Kingdom; Salford Royal NHS Foundation Trust, Rheumatology, Manchester, United Kingdom
Aggarwal, R. (author)
University of Pittsburgh School of Medicine, Division of Rheumatology and Clinical Immunology, Pittsburgh, United States of America
Gupta, L. (author)
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Clinical Immunology and Rheumatology, Lucknow, India; The Royal Wolverhampton NHS Trust, Dept. of Rheumatology, Wolverhampton, United Kingdom
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Fondazione IR.C.C.S. Policlinico San Matteo, Rheumatology, Pavia, Italy; The University of Pavia, Department of Internal Medicine and Medical Therapeutics, Pavia, Italy University of Illinois College of Medicine at Peoria, Department of Internal Medicine, Peoria, United States of America (creator_code:org_t)
2022-05-23
2022
English.
In: Annals of the Rheumatic Diseases. - : HighWire Press. - 0003-4967 .- 1468-2060. ; 81:Suppl. 1, s. 748-748
Related links:
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  • Journal article (other academic/artistic)
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  • Idiopathic inflammatory myopathies (IIM) are a rare, multisystem, heterogeneous diseases, and contribute to high psychological burden. The patients’ perception of physical health, deteriorating independence and social and environmental relationships may not always be a direct function of disease activity. To face with these aspects, several worldwide specialized organization have recommended the use of patient reported outcome measures (PROMs) both in clinical trials and observational studies to highlight patient’s perception of the disease (1). Unfortunately, data on fatigue scores in IIM is limited.ObjectivesWe compared fatigue VAS scores in patients with IIM, autoimmune diseases (AIDs) and healthy controls (HCs) and triangulated them with PROMIS physical function in a large international cohort made up of answers from the e-survey regarding the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study.MethodsData of 16327 respondents was extracted from the COVAD database on August 31th 2021. VAS fatigue scores were compared between AID, HC and IIM using univariate followed by multivariate analysis after adjusting for baseline differences. We further performed a propensity score matched analysis on 1827 subjects after adjusting for age, gender and ethnicity. The Kruskal-Wallis test was used for continuous variables and chi-square test for categorical variables, and Bonferroni’s correction was applied for the post hoc analyses considering IIMs as a reference group.ResultsWe analyzed answers from 6988 patients, with a mean age of 43.8 years (SD 16.2). The overall percentage of female was 72% and the population ethnicity was mainly composed of White (55.1%), followed by Asian (24.6%), and Hispanic (13.8%). The overall fatigue VAS was 3.6 mm (SD 2.7). IIMs VAS was 4.8 mm (SD 2.6), AIDs 4.5 mm (SD 2.6), and HC 2.8 mm (SD 2.6) (P <0,001). VAS fatigue scores of IIMs were comparable with AIDs (P 0.084), albeit significantly higher than the HCs (P <0,001). Notably, fatigue VAS was lower in IIMs than AIDs in two distinct subsets: inactive disease as defined by the patient’s perception and the “excellent” general health condition group, where IIMs had worse scores (P <0,05). Interestingly, fatigue VAS was comparable in active disease defined by physician assessment, patient perception, based on general functional status, or when defined by steroid dose being prescribed. Notably, after propensity matched analysis of patients adjusting for gender, age and ethnicity (1.827 answers, i.e. 609 subjects per group, P =1) the differences disappeared and IIMs and AIDs had comparable fatigue levels across all levels of disease activity, although the fatigue discrepancies with HCs were substantially confirmed.After application of a multivariate linear regression analysis we found that lower fatigue VAS scores were related to HC (P <0,001), male gender (P <0,001), Asian and Hispanic ethnicities (P <0,001 and 0,003).ConclusionOur study confirms that there is a higher prevalence of fatigue in all the AIDs patients, with comparable VAS scores between IIMs and other AIDs. We can also read our data commenting that females and/or Caucasians patients suffer a higher impact of this manifestation of chronic autoimmune diseases upon their lives. This is why these subjects, to our judgement, should be carefully evaluated during outpatients visits and to whom we should spend some extra time to discuss health related issues and how to improve them.References[1]Regardt, M. et al. OMERACT 2018 Modified Patient-reported Outcome Domain Core Set in the Life Impact Area for Adult Idiopathic Inflammatory Myopathies. J. Rheumatol.46, 1351–1354 (2019).Figure 1.distribution of Fatigue VAS scores in the three population evaluated. IIM idiopathic inflammatory myositis; AID autoimmune diseases; HC healthy controls; * P < 0,05.Disclosure of InterestsNone declared

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)

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