Global disparities in the treatment of idiopathic inflammatory myopathies: results from an international online survey study
No Thumbnail Available
All Authors
Ziade,Nelly
Aoude,Marc
Hmamouchi,Ihsane
R.,Naveen
Lilleker,James B.
Sen,Parikshit
Joshi,Mrudula
Agarwal,Vishwesh
Kardes,Sinan
Day,Jessica
LTHT Author
Tan, Ai Lyn
LTHT Department
NIHR Leeds Biomedical Research Centre
Non Medic
Publication Date
2024
Item Type
Article
Language
Subject
Subject Headings
Abstract
Objectives We aimed to explore current practice and interregional differences in the treatment of idiopathic inflammatory myopathies (IIMs). We triangulated these observations considering countries' gross national income (GNI), disease subtypes, and symptoms using patient-reported information. Methods A cross-sectional ancillary analysis of the 'COVID-19 vaccination in auto-immune disease' (COVAD) e-survey containing demographic characteristics, IIM subtypes (DM, PM, IBM, anti-synthetase syndrome ASSD], immune-mediated necrotizing myopathy IMNM], overlap myopathies OM]), current symptoms (surrogate for organ involvement) and treatments (corticosteroids CS], immunomodulators IM], i.e. antimalarials, immunosuppressants IS], IVIG, biologic treatments and targeted-synthetic small molecules). Treatments were presented descriptively according to continents, GNI, IIM and organ involvement, and associated factors were analysed using multivariable binary logistic regressions. Results Of 18?851 respondents from 94 countries, 1418 with IIM were analysed (age 61?years, 62.5% females). DM (32.4%), IBM (24.5%) and OM (15.8%) were the most common subtypes. Treatment categories included IS (49.4%), CS (38.5%), IM (13.8%) and IVIG (9.4%). Notably, treatments varied across regions, GNI categories (IS mostly used in higher-middle income, IM in lower-middle income, IVIG and biologics largely limited to high-income countries), IIM subtypes (IS and CS associated with ASSD, IM with OM and DM, IVIG with IMNM, and biologic treatments with OM and ASSD) and disease manifestations (IS and CS with dyspnoea). Most inter-regional treatment disparities persisted after multivariable analysis. Conclusion We identified marked regional treatment disparities in a global cohort of IIM. These observations highlight the need for international consensus-driven management guidelines considering patient-centred care and available resources.
Journal
Rheumatology