Laura Nuño-Nuño1, Beatriz Esther Joven2, Patricia E Carreira2, Valentina Maldonado-Romero3, Carmen Larena-Grijalba3, Irene Llorente Cubas4, Eva Tomero4, María Carmen Barbadillo-Mateos5, Paloma García de la Peña Lefebvre6, Lucía Ruiz-Gutiérrez7, Juan Carlos López-Robledillo7, Henry Moruno-Cruz8, Ana Pérez8, Tatiana Cobo-Ibáñez9, Raquel Almodóvar10, Leticia Lojo11, María Jesús García de Yébenes12, Francisco Javier López-Longo13. 1. Servicio de Reumatología, Hospital Universitario La Paz, Madrid, Spain. 2. Servicio de Reumatología, Hospital Universitario Doce de Octubre, Madrid, Spain. 3. Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, Spain. 4. Servicio de Reumatología, Hospital Universitario La Princesa, Madrid, Spain. 5. Servicio de Reumatología, Hospital Universitario Puerta de Hierro, Madrid, Spain. 6. Servicio de Reumatología, Hospital Universitario Madrid Norte Sanchinarro, Madrid, Spain. 7. Servicio de Reumatología, Hospital Universitario Infantil Niño Jesús, Madrid, Spain. 8. Servicio de Reumatología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain. 9. Servicio de Reumatología, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, Madrid, Spain. 10. Servicio de Reumatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain. 11. Servicio de Reumatología, Hospital Universitario Infanta Leonor, Madrid, Spain. 12. Instituto de Salud Musculoesquelética, Madrid, Spain. 13. Servicio de Reumatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Abstract
BACKGROUND: Inflammatory idiopathic myositis (IIM) comprises a heterogeneous group of systemic muscular diseases that can occur together with other connective tissue diseases (CTD), named overlap myositis (OM). The question of whether OM is a distinct entity still remains controversial. AIM: The present study was conducted to assess the clinical and prognostic differences between patients diagnosed with OM, primary polymyositis (PM) and primary dermatomyositis (DM). METHOD: The study consists of a retrospective longitudinal and multicenter series of IIM patients. Patients were classified as OM, PM and DM. Overlap myositis was defined as patients fulfilling criteria for IIM plus criteria for other CTD (namely systemic sclerosis, systemic lupus erythematosus, mixed connective tissue disease, rheumatoid arthritis and primary Sjögren's syndrome). RESULT: A total of 342 patients were included (98 OM, 137 PM and 107 DM). Overlap myositis patients, in comparison with PM and DM, showed significant differences, with more extramuscular involvement, particularly more arthritis (66%, 34.6% and 48.1%, respectively), puffy fingers (49.5%, 11.1% and 24.3%), sclerodactyly (45.4%, 2.2% and 2%), dysphagia (41.8%, 18.2% and 26.4%), Raynaud phenomenon (65.3%, 16.9% and 19.8%), leucopenia (28.9%, 2.2% and 8.4%), thrombocytopenia (8.2%, 2.2% and 1.9%), interstitial lung disease (ILD) (48%, 35% and 30.8%), renal manifestations (13.4%, 3.7% and 1.9%), and more severe infections (41.3%, 26.7% and 21%). No significant differences were found in survival between groups in log rank test (P = 0.106). Multivariate adjusted survival analyses revealed a worse prognosis for severe infections, ILD and baseline elevation of acute phase reactants. CONCLUSION: Overlap myositis stands out as a distinct entity as compared to PM and DM, featuring more extramuscular involvement and more severe infections. Close monitoring is recommended in this subset for early detection and treatment of possible complications.
BACKGROUND: Inflammatory idiopathic myositis (IIM) comprises a heterogeneous group of systemic muscular diseases that can occur together with other connective tissue diseases (CTD), named overlap myositis (OM). The question of whether OM is a distinct entity still remains controversial. AIM: The present study was conducted to assess the clinical and prognostic differences between patients diagnosed with OM, primary polymyositis (PM) and primary dermatomyositis (DM). METHOD: The study consists of a retrospective longitudinal and multicenter series of IIM patients. Patients were classified as OM, PM and DM. Overlap myositis was defined as patients fulfilling criteria for IIM plus criteria for other CTD (namely systemic sclerosis, systemic lupus erythematosus, mixed connective tissue disease, rheumatoid arthritis and primary Sjögren's syndrome). RESULT: A total of 342 patients were included (98 OM, 137 PM and 107 DM). Overlap myositispatients, in comparison with PM and DM, showed significant differences, with more extramuscular involvement, particularly more arthritis (66%, 34.6% and 48.1%, respectively), puffy fingers (49.5%, 11.1% and 24.3%), sclerodactyly (45.4%, 2.2% and 2%), dysphagia (41.8%, 18.2% and 26.4%), Raynaud phenomenon (65.3%, 16.9% and 19.8%), leucopenia (28.9%, 2.2% and 8.4%), thrombocytopenia (8.2%, 2.2% and 1.9%), interstitial lung disease (ILD) (48%, 35% and 30.8%), renal manifestations (13.4%, 3.7% and 1.9%), and more severe infections (41.3%, 26.7% and 21%). No significant differences were found in survival between groups in log rank test (P = 0.106). Multivariate adjusted survival analyses revealed a worse prognosis for severe infections, ILD and baseline elevation of acute phase reactants. CONCLUSION:Overlap myositis stands out as a distinct entity as compared to PM and DM, featuring more extramuscular involvement and more severe infections. Close monitoring is recommended in this subset for early detection and treatment of possible complications.
Authors: Luis Fernando Valladales-Restrepo; Ana Camila Delgado-Araujo; Brayan Stiven Aristizábal-Carmona; Lina María Saldarriaga-Rivera; Jorge Enrique Machado-Alba Journal: Int J Rheumatol Date: 2022-07-05
Authors: Sang Wan Chung; In Seol Yoo; Jinhyun Kim; Seong Wook Kang; Mihye Kwon; Chung Il Joung; In Ah Choi; Sung Hae Chang; Mi Il Kang; Seung Jae Hong; Yeon Ah Lee Journal: Yonsei Med J Date: 2021-05 Impact factor: 2.759
Authors: Katalin Szabó; Levente Bodoki; Melinda Nagy-Vincze; Tibor Béldi; Anett Vincze; Erika Zilahi; József Varga; Gabriella Szűcs; Katalin Dankó; Zoltán Griger Journal: Biomed Res Int Date: 2022-05-02 Impact factor: 3.246