Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences and School of Basic Medicine Peking Union Medical College, Beijing, China.
Rheumatology (Oxford). 2024 Apr 2;63(4):1113-1122. doi: 10.1093/rheumatology/kead351.
To investigate the health-related quality of life (HR-QoL), work productivity and activity impairment and associated factors among patients with idiopathic inflammatory myopathy (IIM).
This was an observational, cross-sectional study. The 189 ambulatory patients with IIM were recruited from May 2019 to May 2022. HR-QoL was measured by the European Quality of Life 5-Dimension (EQ-5D) questionnaire. The Work Productivity and Activity Impairment (WPAI) questionnaire was used to evaluate work productivity and activity impairment. The IIM-related parameters were assessed by the 8-item Manual Muscle Test (MMT-8), Myositis Disease Activity Assessment visual analogue scale (MYOACT), Myositis Damage Index (MDI), Disease Activity Score (DAS) and Physician/Patient Global Assessment (PhGA/PtGA). Quantile regression and ordinal logistic regression were performed to identify the factors, considering EQ-5D or WPAI scores as dependent variables, respectively.
Of the 189 IIM patients enrolled, 60% had DM, 13% had PM and 27% had clinical amyopathic DM. The median EQ-5D score was 1.00 (95% CI 0.73, 1.00), 28% were employed and 45% of overall work was impaired due to health problems. EQ-5D values were positively associated with MMT-8 and negatively with MYOACT, DAS, MDI-global and PhGA/PtGA. For the WPAI, activity impairment was associated with a lower MMT-8 score, older onset age and higher PhGA only in 25th-75th percentile. Increased PtGA was associated with increased activity and overall working productivity impairment in most quantiles (P<0.05).
Multiple disease characteristics were associated with reduced HR-QoL or working productivity impairment in patients with IIM, especially for PtGA.
调查特发性炎性肌病（IIM）患者的健康相关生活质量（HR-QoL）、工作生产力和活动障碍及其相关因素。
这是一项观察性、横断面研究。2019 年 5 月至 2022 年 5 月期间，招募了 189 名门诊 IIM 患者。HR-QoL 通过欧洲生活质量 5 维度（EQ-5D）问卷进行评估。使用工作生产力和活动障碍（WPAI）问卷评估工作生产力和活动障碍。通过 8 项徒手肌力测试（MMT-8）、肌炎疾病活动评估视觉模拟量表（MYOACT）、肌炎损伤指数（MDI）、疾病活动评分（DAS）和医生/患者总体评估（PhGA/PtGA）评估 IIM 相关参数。分别考虑 EQ-5D 或 WPAI 评分作为因变量，进行分位数回归和有序逻辑回归，以确定相关因素。
在纳入的 189 名 IIM 患者中，60%为 DM，13%为 PM，27%为临床无肌病性 DM。EQ-5D 评分中位数为 1.00（95%CI 0.73，1.00），28%的患者有工作，45%的工作因健康问题受到损害。EQ-5D 值与 MMT-8 呈正相关，与 MYOACT、DAS、MDI-global 和 PhGA/PtGA 呈负相关。对于 WPAI，活动障碍与较低的 MMT-8 评分、发病年龄较大和仅在 25%至 75%分位时较高的 PhGA 相关。在大多数分位数中，增加的 PtGA 与活动和总体工作生产力障碍的增加相关（P<0.05）。
多种疾病特征与 IIM 患者的 HR-QoL 或工作生产力障碍降低相关，尤其是对于 PhGA。
