Relapse risk factors and clinical characteristics of idiopathic inflammatory myopathies in 105 patients.

IF 2.9 3区医学 Q2 RHEUMATOLOGY Clinical Rheumatology Pub Date : 2024-11-01 Epub Date: 2024-10-01 DOI:10.1007/s10067-024-07120-1

Jihye Choi, So Hye Nam, Jung Sun Lee, Soo Min Ahn, Seokchan Hong, Yong-Gil Kim, Chang-Keun Lee, Jinseok Kim, Byeongzu Ghang, Bin Yoo

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Abstract

Objective: To identify the risk factors for relapse of idiopathic inflammatory myopathies (IIMs).

Methods: Patients who were newly diagnosed with IIMs and underwent muscle biopsy between 2000 and 2017 at Asan Medical Center were retrospectively reviewed. The relapse of IIMs was defined as the recurrence of muscle or cutaneous manifestations with a ≥50% increase in glucocorticoid dosage after reaching the low-dose glucocorticoid phase with clinically significant improvement. The factors associated with the relapse of IIMs were investigated by Cox proportional hazards analysis.

Results: Of 105 patients with IIMs, relapse was observed in 65 patients (62%). The titer of antinuclear antibody (ANA) was higher in the relapse group than in the non-relapse group (P = 0.033). Multivariable analysis showed that the relapse of IIMs was significantly associated with histopathologic features consistent with IIMs (hazard ratio [HR], 1.69; 95% confidence interval [CI], 1.01-2.83, P = 0.045) and the use of immunosuppressants before relapse (HR, 0.50; 95% CI, 0.29-0.86, P = 0.013). Doubling of ANA titer was also associated with relapse, albeit without statistical significance (HR, 1.13; 95% CI, 1.00-1.27, P = 0.052).

Conclusion: In patients with IIMs, the use of immunosuppressants had a significant negative association with relapse. Administering immunosuppressants from the early period during the initial glucocorticoid tapering phase may be useful in reducing the risk of relapse in patients with IIMs. Key Points • Since idiopathic inflammatory myopathies (IIMs) have a low prevalence, it is poorly understood which factors are associated with the relapse of IIMs. • In this study, about two-thirds of 105 patients with IIMs experienced a relapse of IIMs. • The risk of relapse in patients with IIMs was negatively associated with the use of immunosuppressants during glucocorticoid tapering and low-dose glucocorticoid phase. • Even in less severe cases, the use of immunosuppressants might be a good option for the management of IIMs.

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105 名特发性炎症性肌病患者的复发风险因素和临床特征。

目的：确定特发性炎症性肌病（IIMs）复发的风险因素：确定特发性炎症性肌病（IIMs）复发的风险因素：回顾性分析2000年至2017年间在牙山医疗中心新诊断为特发性炎症性肌病并接受肌肉活检的患者。IIMs复发的定义是：在达到低剂量糖皮质激素阶段且临床症状明显改善后，肌肉或皮肤表现复发，糖皮质激素剂量增加≥50%。通过 Cox 比例危险度分析研究了 IIMs 复发的相关因素：在 105 例 IIM 患者中，有 65 例（62%）复发。复发组的抗核抗体（ANA）滴度高于未复发组（P = 0.033）。多变量分析显示，IIM 的复发与符合 IIM 的组织病理学特征（危险比 [HR]，1.69；95% 置信区间 [CI]，1.01-2.83，P = 0.045）和复发前使用免疫抑制剂（HR，0.50；95% 置信区间 [CI]，0.29-0.86，P = 0.013）显著相关。ANA滴度加倍也与复发有关，但无统计学意义（HR，1.13；95% CI，1.00-1.27，P = 0.052）：结论：在 IIM 患者中，使用免疫抑制剂与复发有显著的负相关。结论：在特发性肌痛患者中，使用免疫抑制剂与复发有明显的负相关。在糖皮质激素减量的初期阶段就使用免疫抑制剂可能有助于降低特发性肌痛患者的复发风险。要点--由于特发性炎症性肌病（IIMs）的发病率较低，人们对哪些因素与 IIMs 复发有关还知之甚少。- 在这项研究中，105 名特发性炎症性肌病患者中约有三分之二复发了特发性炎症性肌病。- IIMs患者的复发风险与糖皮质激素减量和低剂量糖皮质激素阶段使用免疫抑制剂呈负相关。- 即使在不太严重的病例中，使用免疫抑制剂也可能是治疗 IIMs 的一个不错选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Rheumatology 医学-风湿病学

CiteScore

6.90

自引率

2.90%

发文量

441

审稿时长

3 months

期刊介绍： Clinical Rheumatology is an international English-language journal devoted to publishing original clinical investigation and research in the general field of rheumatology with accent on clinical aspects at postgraduate level. The journal succeeds Acta Rheumatologica Belgica, originally founded in 1945 as the official journal of the Belgian Rheumatology Society. Clinical Rheumatology aims to cover all modern trends in clinical and experimental research as well as the management and evaluation of diagnostic and treatment procedures connected with the inflammatory, immunologic, metabolic, genetic and degenerative soft and hard connective tissue diseases.