Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan.
Center for Outcomes Research, Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL, USA.
Rheumatology (Oxford). 2023 Mar 1;62(3):1204-1215. doi: 10.1093/rheumatology/keac441.
The assessment of physical function is fundamental in the management of patients with idiopathic inflammatory myopathies (IIMs). We aimed to investigate the physical function of patients with IIMs compared with those with non-IIM autoimmune rheumatic diseases (AIRDs) utilizing Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function (PF) data obtained in the COVAD study, an international self-reported e-survey assessing the safety of COVID-19 vaccines in AIRDs.
Demographics, AIRD diagnosis, disease activity, and PROMIS PF short form-10a data were extracted from the COVAD database. PROMIS PF-10a scores were compared between disease categories and stratified by disease activity. Factors affecting PROMIS PF-10a scores other than disease activity were identified by multivariable regression analysis in patients with inactive disease.
A total of 1057 IIM patients, 3635 non-IIM AIRD patients and 3981 healthy controls (HCs) responded to the COVAD e-survey from April to August 2021. Using a binomial regression model, the predicted mean of PROMIS PF-10a scores was significantly lower in IIM patients compared with non-IIM AIRD patients or HCs [36.3 (95% CI 35.5, 37.1) vs 41.3 (95% CI 40.2, 42.5) vs 46.2 (95% CI 45.8, 46.6), P < 0.001], irrespective of disease activity. The independent factors for lower PROMIS PF-10a scores in patients with inactive disease were older age, female, longer disease duration, and a diagnosis of inclusion body myositis or polymyositis.
Physical function is significantly impaired in IIMs compared with non-IIM AIRDs or HCs, even in patients with inactive disease. Our study highlights a critical need for better strategies to minimize functional disability in patients with IIMs.
评估躯体功能是特发性炎性肌病（IIM）患者管理的基础。我们旨在利用 COVAD 研究中的患者报告结局测量信息系统（PROMIS）躯体功能（PF）数据，调查 IIM 患者与非 IIM 自身免疫性风湿病（AIRD）患者的躯体功能，该研究是一项评估 AIRD 患者 COVID-19 疫苗安全性的国际在线自报调查。
从 COVAD 数据库中提取人口统计学资料、AIRD 诊断、疾病活动度和 PROMIS PF 短表-10a 数据。比较不同疾病类别的 PROMIS PF-10a 评分，并按疾病活动度分层。在疾病活动度无的患者中，采用多变量回归分析确定除疾病活动度以外影响 PROMIS PF-10a 评分的因素。
2021 年 4 月至 8 月期间，共有 1057 例 IIM 患者、3635 例非 IIM AIRD 患者和 3981 名健康对照者（HCs）对 COVAD 在线调查做出了回应。使用二项回归模型，与非 IIM AIRD 患者或 HCs 相比，IM 患者的 PROMIS PF-10a 评分的预测平均值显著更低[36.3（95%CI 35.5，37.1）比 41.3（95%CI 40.2，42.5）比 46.2（95%CI 45.8，46.6），P<0.001]，且与疾病活动度无关。疾病活动无的患者中，PROMIS PF-10a 评分较低的独立因素为年龄较大、女性、疾病病程较长以及包涵体肌炎或多发性肌炎的诊断。
与非 IIM AIRD 或 HCs 相比，即使在疾病活动无的患者中，IM 患者的躯体功能也显著受损。我们的研究强调，迫切需要制定更好的策略来尽量减少 IIM 患者的功能障碍。
