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日本散发性包涵体肌炎的更新回顾性问卷调查研究。

The updated retrospective questionnaire study of sporadic inclusion body myositis in Japan.

机构信息

Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.

Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.

出版信息

Orphanet J Rare Dis. 2019 Jun 26;14(1):155. doi: 10.1186/s13023-019-1122-5.

Abstract

BACKGROUND

Sporadic inclusion body myositis (sIBM) is the most prevalent muscle disease in elderly people, affecting the daily activities. sIBM is progressive with unknown cause and without effective treatment. In 2015, sIBM was classified as an intractable disease by the Japanese government, and the treatment cost was partly covered by the government. This study aimed to examine the changes in the number of patients with sIBM over the last 10 years and to elucidate the cross-sectional profile of Japanese patients with sIBM.

METHODS

The number of sIBM patients was estimated through a reply-paid postcard questionnaire for attending physicians. Only patients diagnosed as "definite" or "probable" sIBM by clinical and biopsy sIBM criteria were included in this study (Lancet Neurol 6:620-631, 2007, Neuromuscul Disord 23:1044-1055, 2013). Additionally, a registered self-administered questionnaire was also sent to 106 patients who agreed to reply via their attending physician, between November 2016 and March 2017.

RESULTS

The number of patients diagnosed with sIBM for each 5-year period was 286 and 384 in 2011 and 2016, respectively. Inability to stand-up, cane-dependent gait, inability to open a plastic bottle, choking on food ingestion, and being wheelchair-bound should be included as sIBM milestones. Eight patients were positive for anti-hepatitis C virus antibody; three of them were administered interferon before sIBM onset. Steroids were administered to 33 patients (31.1%) and intravenous immunoglobulin to 46 patients (43.4%). From 2016 to 2017, total of 70 patients applied for the designated incurable disease medical expenses subsidy program. Although the treatment cost was partly covered by the government, many patients expressed psychological/mental and financial anxieties.

CONCLUSIONS

We determined the cross-sectional profile of Japanese patients with sIBM. Continuous support and prospective surveys are warranted.

摘要

背景

散发性包涵体肌炎(sIBM)是老年人中最常见的肌肉疾病,影响日常活动。sIBM 呈进行性发展,病因不明,尚无有效治疗方法。2015 年,日本政府将 sIBM 列为难治性疾病,部分治疗费用由政府承担。本研究旨在调查过去 10 年 sIBM 患者数量的变化,并阐明日本 sIBM 患者的横断面特征。

方法

通过回复明信片问卷调查对主治医生进行估计。本研究仅纳入符合临床和活检 sIBM 标准诊断为“明确”或“可能”sIBM 的患者(《柳叶刀神经病学》6:620-631,2007 年;《神经肌肉疾病》23:1044-1055,2013 年)。此外,2016 年 11 月至 2017 年 3 月,还向 106 名同意通过主治医生回复的患者发送了一份已注册的自我管理问卷。

结果

2011 年和 2016 年,每 5 年诊断为 sIBM 的患者人数分别为 286 人和 384 人。无法站立、依赖拐杖行走、无法打开塑料瓶、吞咽食物时呛咳、以及需要坐轮椅应作为 sIBM 的里程碑。8 名患者抗丙型肝炎病毒抗体阳性;其中 3 人在 sIBM 发病前接受了干扰素治疗。33 名患者(31.1%)接受了类固醇治疗,46 名患者(43.4%)接受了静脉注射免疫球蛋白治疗。2016 年至 2017 年,共有 70 名患者申请指定的不治之症医疗费用补贴计划。尽管政府部分承担了治疗费用,但许多患者表示存在心理/精神和经济焦虑。

结论

我们确定了日本 sIBM 患者的横断面特征。需要持续的支持和前瞻性调查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02ac/6595668/aba6bb7cd203/13023_2019_1122_Fig1_HTML.jpg

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