TY - JOUR
T1 - Global disparities in the treatment of idiopathic inflammatory myopathies
T2 - results from an international online survey study
AU - COVAD Study Group
AU - Ziade, Nelly
AU - Aoude, Marc
AU - Hmamouchi, Ihsane
AU - Naveen, R.
AU - Lilleker, James B.
AU - Sen, Parikshit
AU - Joshi, Mrudula
AU - Agarwal, Vishwesh
AU - Kardes, Sinan
AU - Day, Jessica
AU - Makol, Ashima
AU - Milchert, Marcin
AU - Gheita, Tamer
AU - Salim, Babur
AU - Velikova, Tsvetelina
AU - Gracia-Ramos, Abraham Edgar
AU - Parodis, Ioannis
AU - Nikiphorou, Elena
AU - Chatterjee, Tulika
AU - Tan, Ai Lyn
AU - Saavedra, Miguel A.
AU - Shinjo, Samuel Katsuyuki
AU - Knitza, Johannes
AU - Kuwana, Masataka
AU - Nune, Arvind
AU - Cavagna, Lorenzo
AU - Distler, Oliver
AU - Chinoy, Hector
AU - Agarwal, Vikas
AU - Aggarwal, Rohit
AU - Gupta, Latika
AU - Barman, Bhupen
AU - Singh, Yogesh Preet
AU - Ranjan, Rajiv
AU - Jain, Avinash
AU - Pandya, Sapan C.
AU - Pilania, Rakesh Kumar
AU - Sharma, Aman
AU - Manesh, Manoj M.
AU - Gupta, Vikas
AU - Kavadichanda, Chengappa G.
AU - Patro, Pradeepta Sekhar
AU - Ajmani, Sajal
AU - Phatak, Sanat
AU - Goswami, Rudra Prosad
AU - Chowdhury, Abhra Chandra
AU - Mathew, Ashish Jacob
AU - Shenoy, Padnamabha
AU - Asranna, Ajay
AU - Kaneko, Yuko
N1 - Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
PY - 2024/3/1
Y1 - 2024/3/1
N2 - 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.
AB - 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.
KW - equity
KW - equity
KW - inflammatory myopathies
KW - myositis
KW - rheumatic disease
KW - survey
KW - treatment
UR - https://www.scopus.com/pages/publications/85174313634
UR - https://www.scopus.com/pages/publications/85174313634#tab=citedBy
U2 - 10.1093/rheumatology/kead250
DO - 10.1093/rheumatology/kead250
M3 - Article
C2 - 37228012
AN - SCOPUS:85174313634
SN - 1462-0324
VL - 63
SP - 657
EP - 664
JO - Rheumatology (United Kingdom)
JF - Rheumatology (United Kingdom)
IS - 3
ER -
SDG 3 Good Health and Well-being