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TREATMENT PATTERNS OF IDIOPATHIC INFLAMMATORY MYOPATHIES : RESULTS FROM AN INTERNATIONAL COHORT OF OVER 1,400 PATIENTS
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- Aoude, M. (författare)
- Saint Joseph University of Beirut, Rheumatology Department, Beirut, Lebanon
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- Gupta, L. (författare)
- 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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- Hmamouchi, I. (författare)
- Temara Hospital, Rheumatology Unit, Temara, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University, Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Rabat, Morocco
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- Grignaschi, S. (författare)
- 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
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- Cavagna, L. (författare)
- 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
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- Kim, M. (författare)
- University of Illinois College of Medicine at Peoria, Department of Internal Medicine, Peoria, United States of America
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- R, N. (författare)
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Clinical Immunology and Rheumatology, Lucknow, India
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- Lilleker, J. B. (författare)
- 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
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- Sen, P. (författare)
- Maulana Azad Medical College(MAMC), Rheumatology, New Delhi, India
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- Agarwal, V. (författare)
- Mahatma Gandhi Mission Medical College, Navi Mumbai, India
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- Kardes, S. (författare)
- Istanbul University Faculty of Medicine, Department of Medical Ecology and Hydroclimatology, Istanbul, Turkey
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- Day, J. (författare)
- 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
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- Makol, A. (författare)
- Mayo Clinic, Division of Rheumatology, Rochester, United States of America
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- Milchert, M. (författare)
- Pomeranian Medical University, Department of Rheumatology, Internal Medicine, Geriatrics and Clinical Immunology, Szczecin, Poland
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- Gheita, T. A. (författare)
- Faculty Of Medicine Kasr Al-Ainy Cairo University, Rheumatology Department, Cairo, Egypt
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- Salim, B. (författare)
- Fauji Foundation Hospital Road, Rheumatology Department, Rawalpindi, Pakistan
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- Velikova, T. (författare)
- Lozenetz University Hospital, Department of Clinical Immunology, Sofia, Bulgaria
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- Gracia-Ramos, A. E. (författare)
- MSS, Department of Internal Medicine, Ciudad de México, Mexico
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- Parodis, Ioannis, 1981- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Karolinska University Hospital, Division of Rheumatology, Stockholm, Sweden; Örebro University, Department of Rheumatology, Örebro, Sweden
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- Selva-O'callaghan, A. (författare)
- La Vall d’Hebron, Systemic Autoimmune Diseases Unit, Internal Medicine Department, Barcelona, Spain
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- Nikiphorou, E. (författare)
- King’s College London, Centre for Rheumatic Diseases, London, United Kingdom; King’s College Hospital, Dept of Rheumatology, London, United Kingdom
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- Chatterjee, T. (författare)
- University of Illinois College of Medicine at Peoria, Department of Internal Medicine, Peoria, United States of America
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- Tan, A. L. (författare)
- Leeds General Infirmary, NIHR Leeds Biomedical Research Centre, Leeds, United Kingdom; University of Leeds, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, United Kingdom
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- Saavedra, M. A. (författare)
- Centro Medico Nacional La Raza, Departamento de Reumatología, Ciudad de México, Mexico
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- Shinjo, S. Katsuyuki (författare)
- Centro Medico Nacional La Raza, Departamento de Reumatología, Ciudad de México, Mexico
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- Knitza, J. (författare)
- University of Erlangen-Nuremberg, Medizinische Klinik 3 - Rheumatologie und Immunologie, Erlangen, Germany
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- Kuwana, M. (författare)
- Nippon Medical School, Department of Allergy and Rheumatology, Bunkyo City, Japan
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- Nune, A. (författare)
- Southport & Ormskirk Hospital NHS Trust, Southport, United Kingdom
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- Distler, O. (författare)
- University Hospital of Zürich, Rheumatology, Zürich, Switzerland
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- Chinoy, H. (författare)
- 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
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- Aggarwal, R. (författare)
- University of Pittsburgh School of Medicine, Division of Rheumatology and Clinical Immunology, Pittsburgh, United States of America
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- Ziade, N. (författare)
- Saint Joseph University of Beirut, Rheumatology Department, Beirut, Lebanon; Hôtel-Dieu de France, Rheumatology Department, Beirut, Lebanon
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Saint Joseph University of Beirut, Rheumatology Department, Beirut, Lebanon 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 (creator_code:org_t)
- 2022-05-23
- 2022
- Engelska.
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Ingår i: Annals of the Rheumatic Diseases. - : HighWire Press. - 0003-4967 .- 1468-2060. ; 81:Suppl. 1, s. 105-106
- Relaterad länk:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Idiopathic inflammatory myopathies (IIM) are a group of heterogeneous autoimmune disorders with limited standardization of treatment protocols.ObjectivesTo evaluate frequency and patterns of various treatments used for IIM based on disease subtype, world region, and organ involvement.MethodsCross-sectional data from the international CoVAD self-report e-survey1 was extracted on Sep 14th, 2021. Patient details included demographics, IIM subtypes (dermatomyositis (DM), polymyositis (PM), inclusion body myositis (IBM), antisynthetase syndrome (ASSD), necrotizing myositis (NM) and overlap myositis (OM)), clinical symptoms, disease duration and activity, and current treatments. Treatments were categorized in corticosteroids (CS), antimalarials, immunosuppressants (IS), intravenous immunoglobulins (IVIG), biologics, and others. Typical clinical symptoms (dyspnea, dysphagia) were used as surrogate for organ involvement. Factors associated with IS were analyzed using multivariable logistic regression, adjusting for IIM subtype, demographics, world region, disease activity, and prevalent clinical symptoms (>10%).ResultsIn 1418 patients with IIM, median age was 61 years [IQR 49-70], 62.5% were females, median disease duration was 6 years [IQR 3-11], most common subset was DM (32.4%).The most used treatments were IS (49.4%, including Methotrexate 19.6%, Mycophenolate Mofetil 18.2%, Azathioprine 8.8%, Cyclosporine 2.7%, Tacrolimus 2%, Leflunomide 1.6%, Sulfasalazine 1%, and Cyclophosphamide 0.6%), followed by CS (40.8%), antimalarials (13.8%) and IVIG (9.4%). Biologics were used in 4.3% of patients.Treatment patterns differed significantly by IIM subtypes with a higher frequency of IS (77.7%) and CS (63.4%) use in ASSD; antimalarials (28.6%) and biologics (9.8%) use in OM and IVIG use in NM (24.6%) (Table 1). Also, treatment patterns were different in regions of the world (Figure 1), with a higher frequency of CS use in Europe (60.5%) and IS use in South America (77.2%). Antimalarials were most used in Asia (19.4%), while IVIG use was most common in Oceania (16.9%). Dyspnea was associated with higher use of IS (69.9%) and CS (65.8%) (p<0.001), whereas dysphagia was negatively associated with IS (39.7%) and CS (32.7%) likely due to a higher proportion in IBM patients reporting dysphagia.Table 1.Current Treatments for IIM, Stratified by Disease SubtypesDermatomyositisPolymyositisInclusion Body MyositisAnti-synthetase syndromeNecrotizing myositisOverlap syndromeAll IIMp-valueNumber of patients459182348148572241418Immunosuppressants*269 (58.6)107 (58.8)39 (11.2)115 (77.7)40 (70.2)130 (58.0)700 (49.4)<0.001Corticosteroids208 (48.0)81 (46.8)32 (9.7)90 (63.4)32 (59.3)103 (50.0)546 (40.8)<0.001Antimalarials99 (21.6)7 (3.8)0 (0.0)25 (16.9)1 (1.8)64 (28.6)196 (13.8)<0.001Intravenous Immunoglobulins54 (11.8)16 (8.8)19 (5.5)10 (6.8)14 (24.6)20 (8.9)133 (9.4)<0.001Biologics**17 (3.7)7 (3.8)0 (0.0)13 (8.8)2 (3.5)22 (9.8)61 (4.3)<0.001Others***6 (1.3)0 (0.0)0 (0.0)1 (0.7)0 (0.0)5 (2,2)12 (0.8)0.098*Methotrexate (278), Mycophenolate Mofetil (258), Azathioprine (125), Cyclosporine (38), Tacrolimus (28), Leflunomide (23), Sulfasalazine (14), Cyclophosphamide (9). **Rituximab (44), Abatacept (5), TNF inhibitors (4), Tocilizumab (3), Belimumab (3), Secukinumab (1). ***JAK(10) and PDE4 inhibitors (2)Multivariable logistic regression analysis showed an association of IS with the IIM subtype (least used in IBM (OR 0.07 [95%CI 0.04-0.13] compared to DM), world region (most used in South America (OR 2.35 [1.12-4.91] compared to North America), active and worsening disease activity (OR 3.49 [1.76-6.91] compared to remission), and some clinical features (dyspnea, fatigue, and muscle weakness).ConclusionIIM treatment patterns differ significantly by disease subtypes, world regions and organ involvement, highlighting the need for unified international consensus-driven guidelines.References[1]Parikshit S. et al. Rheumatol Int. 2022 Jan;42(1):23–9.Disclosure of InterestsNone declared
Ämnesord
- 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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Aoude, M.
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Gupta, L.
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Hmamouchi, I.
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Grignaschi, S.
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Cavagna, L.
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Kim, M.
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visa fler...
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R, N.
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Lilleker, J. B.
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Sen, P.
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Agarwal, V.
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Kardes, S.
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Day, J.
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Makol, A.
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Milchert, M.
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Gheita, T. A.
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Salim, B.
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Velikova, T.
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Gracia-Ramos, A. ...
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Parodis, Ioannis ...
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Selva-O'callagha ...
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Nikiphorou, E.
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Chatterjee, T.
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Tan, A. L.
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Saavedra, M. A.
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Shinjo, S. Katsu ...
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Knitza, J.
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Kuwana, M.
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Nune, A.
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Distler, O.
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Chinoy, H.
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Aggarwal, R.
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Ziade, N.
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