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Age, gender among factors associated with severity of PM/DM symptoms
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Age at the time of disease onset, gender and the initial dose of prednisolone were significantly associated with the severity of physical dysfunction in the treatment of polymyositis and dermatomyositis, according to research presented at the American College of Rheumatology Annual Meeting.
Clinical data were obtained retrospectively for 77 patients diagnosed with polymyositis (PM), dermatomyositis (DM) or clinically amyopathic DM between December 1991 and February 2013. Patients met either Bohan and Peter or Sontheimer criteria. Median patient age was 46 years, and 79% of the patients were women.
Data included age of disease onset, gender and duration of disease, as well as results of laboratory tests prior to treatment, such as serum creatine kinase and myositis-specific autoantibodies (MSAs). Other data collected included the presence of relapse and treatment information.
The physical dysfunction of each patients was measured between August and October 2013 using the Health Assessment Questionnaire Disability Index (HAQ-DI), and data were retrospectively analyzed prior to treatment to assess predictors of dysfunction severity after treatment.
Multivariate analysis showed the age of disease onset and the initial dose of prednisolone were associated with disease severity after treatment. Additionally, women were almost three times as likely to have a more severe HAQ-DI score after treatment, according to the researchers. Serum levels of creatine kinase, the administration of methylprednisolone pulse therapy and disease relapse were not associated with disease severity post-treatment.
Of MSAs, the researchers found anti-SRP positivity was associated with more severe physical dysfunction than other MSAs, and anti-MDA-5 positivity was associates with better physical function after treatment onset. – by Shirley Pulawski
Reference:
Kawasumi H, et al. Paper #1264. Presented at: American College of Rheumatology Annual Meeting. Nov. 14-19, 2014; Boston.
Disclosure: The authors have no relevant financial disclosures.