Global disparities in the treatment of idiopathic inflammatory myopathies: results from an international online survey study

Ziade, N; Aoude, M; Hmamouchi, I; R, N; Lilleker, JB; Sen, P; Joshi, M; Agarwal, V; Kardes, S; Day, J; Makol, A; Milchert, M; Gheita, T; Salim, B; Velikova, T; Edgar Gracia-Ramos, A; Parodis, I; Nikiphorou, E; Chatterjee, T; Tan, AL; Saavedra, MA; Shinjo, SK; Knitza, J; Kuwana, M; Nune, A; Cavagna, L; Distler, O; Chinoy, H; Agarwal, V; Aggarwal, R; Gupta, L

Author(s): Ziade, N; Aoude, M; Hmamouchi, I; R, N; Lilleker, JB; Sen, P; Joshi, M; Agarwal, V; Kardes, S; Day, J; Makol, A; Milchert, M; Gheita, T; Salim, B; Velikova, T; Edgar Gracia-Ramos, A; Parodis, I; Nikiphorou, E; Chatterjee, T; Tan, AL; Saavedra, MA; Shinjo, SK; Knitza, J; Kuwana, M; Nune, A; Cavagna, L; Distler, O; Chinoy, H; Agarwal, V; Aggarwal, R; Gupta, L;
Details: Publication Year 2024-03-01,Volume 63,Issue #3,Page 657-664
Journal Title: Rheumatology
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.
Keywords: Female; Humans; Middle Aged; Male; COVID-19 Vaccines; Cross-Sectional Studies; Immunoglobulins, Intravenous/therapeutic use; *Myositis/drug therapy; Immunosuppressive Agents/therapeutic use; *Autoimmune Diseases; Adjuvants, Immunologic; equity; inflammatory myopathies; myositis; rheumatic disease; survey; treatment
Research Division(s): Inflammation
PubMed ID: 37228012
Publisher's Version: https://doi.org/10.1093/rheumatology/kead250
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-03-11 09:24:58

Last Modified: 2024-03-11 09:35:23