Cobo-Ibáñez Tatiana, Castellví Ivan, Pros Ana, Domínguez-Álvaro Marta, Nuño-Nuño Laura, Martínez-Barrio Julia, Jovaní Vega, Romero-Bueno Fredeswinda, Ruiz-Lucea Esther, Tomero Eva, Trallero-Araguás Ernesto, Narváez Javier, Camins-Fàbregas Jordi, Ruiz-Román Alberto, Loarce-Martos Jesús, Holgado-Pérez Susana, Flores-Rodríguez V Miguel, Sivera Francisca, Merino-Argumanez Carolina, Juan-Mas Antonio, Altabás-González Irene, Martín-López María, Belzunegui-Otano Joaquín María, Carrasco-Cubero Carmen, Freire-González Mercedes, Rúa-Figueroa Iñigo, Lozano-Rivas Nuria, Suarez-Cuba Julio David, Martínez Olga, Ortega-Castro Rafaela, Alcocer Patricia, Gómez-Gómez Alejandro, Sánchez-Pernaute Olga, Tandaipan José Luis, Carrión-Barberà Irene, Plasencia-Rodríguez Chamaida, Ibarguengoitia-Barrena Oihane, Vidal-Montal Paola, Ortiz-Santamaria Vera, Garrido-Puñal Noemi, Riveros Anne, Delgado-Frías Esmeralda, López-Gómez Juan Miguel, Barbadillo Carmen, Pego-Reigosa José María, Joven-Ibáñez Beatriz E, Valero-Jaimes Jesús Alejandro, Naveda Elena, Turrión-Nieves Ana Isabel, Seoane-Mato Daniel, Prado-Galbarro Francisco Javier, Puche-Larrubia M Ángeles
Rheumatology Department, Hospital Universitario Infanta Sofía, Paseo de Europa 34, San Sebastián de los Reyes, Madrid, 28702, Spain.
Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain.
Arthritis Res Ther. 2025 Jan 8;27(1):5. doi: 10.1186/s13075-024-03471-x.
To evaluate the main outcomes of disease activity and their association with other measures of activity, damage, and quality of life in patients with idiopathic inflammatory myopathy (IIM) according to time since diagnosis and positivity to antisynthetase autoantibodies (ASAs).
Cross-sectional multicenter study within the Spanish Myo-Spain registry. Cases were classified as incident (≤ 12 months since diagnosis) and prevalent. The main outcomes of disease activity were the Myositis Disease Activity Assessment visual analogue scale (MYOACT), the Manual Muscle Test 8 (MMT-8), physician global activity (PhGA), and extramuscular activity. Other measures of activity, damage, and quality of life included patient global disease activity, MYOACT muscular, creatine phosphokinase, Health Assessment Questionnaire, physician and patient global damage, global damage of the Myositis Damage Index, and the 12-item Short-Form Health Survey (SF-12). We analyzed associations using a multivariate generalized linear model and a simple linear regression model.
A total of 554 patients with different diagnostic subgroups of IIM were included (136 incident and 418 prevalent cases), with 215 ASA-positive patients (58 incident and 157 prevalent cases). All measures of disease activity were higher in the incident cases (p < 0.05), except for MYOACT muscular and creatine phosphokinase, for which no differences were recorded in ASA-positive patients. No differences were found between incident and prevalent cases for measures of damage. Values for the physical component of the SF-12 were higher in the prevalent cases (p < 0.05). The multivariate model was initially significant overall for the main activity outcomes. Positivity to ASAs was positively and negatively associated with the MYOACT index and MMT-8, respectively (p < 0.05), although no association was recorded with PhGA and extramuscular activity. Prevalent cases were negatively associated with the main outcomes of activity, except with MMT-8, for which the association was positive (p < 0.05).
The main activity outcomes validated in polymyositis and dermatomyositis could also be used in other subtypes of IIM, such as antisynthetase syndrome. Recent diagnosis is associated with greater disease activity, as assessed based on these activity outcomes. PhGA and extramuscular activity are not modified by ASA positivity, thus supporting their preferred use for assessing treatment response in IIM with ASAs.
根据诊断后的时间以及抗合成酶自身抗体（ASA）的阳性情况，评估特发性炎性肌病（IIM）患者疾病活动的主要结局及其与其他活动、损伤和生活质量指标的关联。
在西班牙Myo-Spain注册研究中进行的横断面多中心研究。病例分为新发（诊断后≤12个月）和患病病例。疾病活动的主要结局包括肌炎疾病活动评估视觉模拟量表（MYOACT）、徒手肌力测试8（MMT-8）、医生整体活动评分（PhGA）和肌肉外活动。其他活动、损伤和生活质量指标包括患者整体疾病活动度、MYOACT肌肉评分、肌酸磷酸激酶、健康评估问卷、医生和患者整体损伤、肌炎损伤指数的整体损伤以及12项简短健康调查问卷（SF-12）。我们使用多变量广义线性模型和简单线性回归模型分析关联。
共纳入554例IIM不同诊断亚组的患者（136例新发和418例患病病例），其中215例ASA阳性患者（58例新发和157例患病病例）。除MYOACT肌肉评分和肌酸磷酸激酶外，所有疾病活动指标在新发病例中均更高（p<0.05），在ASA阳性患者中这两项指标未记录到差异。在损伤指标方面，新发和患病病例之间未发现差异。SF-12身体成分评分在患病病例中更高（p<0.05）。多变量模型最初对主要活动结局总体具有显著意义。ASA阳性分别与MYOACT指数呈正相关、与MMT-8呈负相关（p<0.05），尽管未记录到与PhGA和肌肉外活动的关联。患病病例与主要活动结局呈负相关，但与MMT-8呈正相关（p<0.05）。
在多发性肌炎和皮肌炎中验证的主要活动结局也可用于IIM的其他亚型，如抗合成酶综合征。根据这些活动结局评估，近期诊断与更高的疾病活动度相关。PhGA和肌肉外活动不受ASA阳性的影响，因此支持它们优先用于评估伴有ASA的IIM的治疗反应。
