Global disparities in the treatment of idiopathic inflammatory myopathies : results from an international online survey study
© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissionsoup.com..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:63 |
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| Enthalten in: |
Rheumatology (Oxford, England) - 63(2024), 3 vom: 01. März, Seite 657-664 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ziade, Nelly [VerfasserIn] |
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| Links: |
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| Themen: |
Adjuvants, Immunologic |
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| Anmerkungen: |
Date Completed 04.03.2024 Date Revised 04.03.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/rheumatology/kead250 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM357303733 |
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| 245 | 1 | 0 | |a Global disparities in the treatment of idiopathic inflammatory myopathies |b results from an international online survey study |
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| 500 | |a Date Revised 04.03.2024 | ||
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| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a equity | |
| 650 | 4 | |a inflammatory myopathies | |
| 650 | 4 | |a myositis | |
| 650 | 4 | |a rheumatic disease | |
| 650 | 4 | |a survey | |
| 650 | 4 | |a treatment | |
| 650 | 7 | |a COVID-19 Vaccines |2 NLM | |
| 650 | 7 | |a Immunoglobulins, Intravenous |2 NLM | |
| 650 | 7 | |a Immunosuppressive Agents |2 NLM | |
| 650 | 7 | |a Adjuvants, Immunologic |2 NLM | |
| 700 | 1 | |a Aoude, Marc |e verfasserin |4 aut | |
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| 700 | 1 | |a Lilleker, James B |e verfasserin |4 aut | |
| 700 | 1 | |a Sen, Parikshit |e verfasserin |4 aut | |
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| 700 | 1 | |a Agarwal, Vishwesh |e verfasserin |4 aut | |
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| 700 | 1 | |a Edgar Gracia-Ramos, Abraham |e verfasserin |4 aut | |
| 700 | 1 | |a Parodis, Ioannis |e verfasserin |4 aut | |
| 700 | 1 | |a Nikiphorou, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Chatterjee, Tulika |e verfasserin |4 aut | |
| 700 | 1 | |a Tan, Ai Lyn |e verfasserin |4 aut | |
| 700 | 1 | |a Saavedra, Miguel A |e verfasserin |4 aut | |
| 700 | 1 | |a Shinjo, Samuel Katsuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Knitza, Johannes |e verfasserin |4 aut | |
| 700 | 1 | |a Kuwana, Masataka |e verfasserin |4 aut | |
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| 700 | 1 | |a Barman, Bhupen |e investigator |4 oth | |
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| 700 | 1 | |a Jain, Avinash |e investigator |4 oth | |
| 700 | 1 | |a Pandya, Sapan C |e investigator |4 oth | |
| 700 | 1 | |a Pilania, Rakesh Kumar |e investigator |4 oth | |
| 700 | 1 | |a Sharma, Aman |e investigator |4 oth | |
| 700 | 1 | |a Manesh Manoj, M |e investigator |4 oth | |
| 700 | 1 | |a Gupta, Vikas |e investigator |4 oth | |
| 700 | 1 | |a Kavadichanda, Chengappa G |e investigator |4 oth | |
| 700 | 1 | |a Patro, Pradeepta Sekhar |e investigator |4 oth | |
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| 700 | 1 | |a Phatak, Sanat |e investigator |4 oth | |
| 700 | 1 | |a Goswami, Rudra Prosad |e investigator |4 oth | |
| 700 | 1 | |a Chowdhury, Abhra Chandra |e investigator |4 oth | |
| 700 | 1 | |a Mathew, Ashish Jacob |e investigator |4 oth | |
| 700 | 1 | |a Shenoy, Padnamabha |e investigator |4 oth | |
| 700 | 1 | |a Asranna, Ajay |e investigator |4 oth | |
| 700 | 1 | |a Bommakanti, Keerthi Talari |e investigator |4 oth | |
| 700 | 1 | |a Shukla, Anuj |e investigator |4 oth | |
| 700 | 1 | |a Pandey, Arun Kumar R |e investigator |4 oth | |
| 700 | 1 | |a Chandwar, Kunal |e investigator |4 oth | |
| 700 | 1 | |a Cansu, Döndü Üsküdar |e investigator |4 oth | |
| 700 | 1 | |a Pauling, John D |e investigator |4 oth | |
| 700 | 1 | |a Wincup, Chris |e investigator |4 oth | |
| 700 | 1 | |a Del Papa, Nicoletta |e investigator |4 oth | |
| 700 | 1 | |a Sambataro, Gianluca |e investigator |4 oth | |
| 700 | 1 | |a Fabiola, Atzeni |e investigator |4 oth | |
| 700 | 1 | |a Govoni, Marcello |e investigator |4 oth | |
| 700 | 1 | |a Parisi, Simone |e investigator |4 oth | |
| 700 | 1 | |a Bocci, Elena Bartoloni |e investigator |4 oth | |
| 700 | 1 | |a Sebastiani, Gian Domenico |e investigator |4 oth | |
| 700 | 1 | |a Fusaro, Enrico |e investigator |4 oth | |
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| 700 | 1 | |a Yoshida, Akira |e investigator |4 oth | |
| 700 | 1 | |a Nakashima, Ran |e investigator |4 oth | |
| 700 | 1 | |a Sato, Shinji |e investigator |4 oth | |
| 700 | 1 | |a Kimura, Naoki |e investigator |4 oth | |
| 700 | 1 | |a Kaneko, Yuko |e investigator |4 oth | |
| 700 | 1 | |a Tomaras, Stylianos |e investigator |4 oth | |
| 700 | 1 | |a Gromova, Margarita Aleksandrovna |e investigator |4 oth | |
| 700 | 1 | |a Aharonov, Or |e investigator |4 oth | |
| 700 | 1 | |a Hoff, Leonardo Santos |e investigator |4 oth | |
| 700 | 1 | |a Giannini, Margherita |e investigator |4 oth | |
| 700 | 1 | |a Maurier, François |e investigator |4 oth | |
| 700 | 1 | |a Campagne, Julien |e investigator |4 oth | |
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