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

Ziade N, Aoude M, Hmamouchi I, Naveen R, Lilleker JB, Sen P, Joshi M, Agarwal V, Kardes S, Day J, Makol A, Milchert M, Gheita T, Salim B, Velikova T, Gracia-Ramos AE, 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, Barman B, Singh YP, Ranjan R, Jain A, Pandya SC, Pilania RK, Sharma A, Manesh MM, Gupta V, Kavadichanda CG, Patro PS, Ajmani S, Phatak S, Goswami RP, Chowdhury AC, Mathew AJ, Shenoy P, Asranna A, Bommakanti KT, Shukla A, Pande AR, Chandwar K, Cansu DÜ, Pauling JD, Del Papa CWN, Sambataro G, Fabiola A, Govoni M, Parisi S, Bocci EB, Sebastiani GD, Fusaro E, Sebastiani M, Quartuccio L, Franceschini F, Sainaghi PP, Orsolini G, De Angelis R, Danielli MG, Venerito V, Traboco LS, Kusumo Wibowo SA, Zamora Tehozol EA, Serrano JR, La Torre IGD, Loarce-Martos J, Prieto-González S, Gonzalez RA, Yoshida A, Nakashima R, Sato S, Kimura N, Kaneko Y, Tomaras S, Gromova MA, Aharonov , Hoff LS, Giannini M, Maurier F, Campagne J, Meyer A, Nagy-Vincze M, Langguth D, Limaye V, Needham M, Srivastav N, Hudson M, Landon-Cardinal O, Shaharir SS, Rojas Zuleta WG, Pereira Silva JA, Fonseca JE, Zimba O (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Book Volume: 63

Pages Range: 657-664

Journal Issue: 3

DOI: 10.1093/rheumatology/kead250

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.

Authors with CRIS profile

Involved external institutions

Fauji Foundation Hospital Pakistan (PK) Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) India (IN) University of Manchester United Kingdom (GB) Maulana Azad Medical College (MAMC) India (IN) Byramjee Jeejeebhoy Government Medical College & Sassoon General Hospital India (IN) Mahatma Gandhi Mission Medical College and Hospital India (IN) Istanbul University / İstanbul Üniversitesi Turkey (TR) Royal Melbourne Hospital (RMH) Australia (AU) Mayo Clinic United States (USA) (US) Pomeranian Medical University / Pomorski Uniwersytet Medyczny w Szczecinie (PMU) Poland (PL) Sofia University "St. Kliment Ohridski" / Софийски университет "Св. Климент Охридски" Bulgaria (BG) Instituto Mexicano del Seguro Social Mexico (MX) Karolinska University Hospital / Karolinska Universitetssjukhuset Sweden (SE) King’s College London United Kingdom (GB) University of Illinois at Urbana-Champaign United States (USA) (US) NIHR Leeds Musculoskeletal Biomedical Research Unit (LMBRU) United Kingdom (GB) Centro Medico Nacional Siglo XXI Mexico (MX) University of São Paulo / Universidade de São Paulo (USP) Brazil (BR) Southport and Ormskirk Hospital NHS Trust United Kingdom (GB) Policlinico San Matteo Pavia Fondazione IRCCS Italy (IT) Universitätsspital Zürich (USZ) Switzerland (CH) International University of Rabat (IUR) / الجامعة الدولية للرباط Morocco (MA) University of Pittsburgh United States (USA) (US) The Royal Wolverhampton NHS Trust / Royal Wolverhampton Hospitals NHS Trust United Kingdom (GB) Université Saint-Joseph (USJ) / جامعة القديس يوسف / Սուրբ Ժոզեֆի համալսարան Lebanon (LB) Mohammed V University (UMVA) / جامعة محمد الخامس‎ Morocco (MA)

How to cite

APA:

Ziade, N., Aoude, M., Hmamouchi, I., Naveen, R., Lilleker, J.B., Sen, P.,... Zimba, O. (2024). Global disparities in the treatment of idiopathic inflammatory myopathies: results from an international online survey study. Rheumatology, 63(3), 657-664. https://doi.org/10.1093/rheumatology/kead250

MLA:

Ziade, Nelly, et al. "Global disparities in the treatment of idiopathic inflammatory myopathies: results from an international online survey study." Rheumatology 63.3 (2024): 657-664.

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