The impact of multimorbidity on QoL in inflammatory myopathies: COVAD cluster analysis.
Journal: Rheumatology (Oxford, England)
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Affiliated Institutions:
University of Bari, Department of Precision and Regenerative Medicine and Ionian Area, Rheumatology Unit, Bari, Italy.
University of Milan, , Italy, Milan.
Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India.
Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan.
NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UK.
Mymensingh Medical College, Mymensingh, Bangladesh.
Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Illinois.
Mahatma Gandhi Mission Medical College, Navi Mumbai, Maharashtra, India.
Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
School of Medicine, Universidade Potiguar (UnP), Brazil.
Seth Gordhandhas Sunderdas Medical College and King Edwards Memorial Hospital, Mumbai, Maharashtra, India.
Rheumatology Department, Saint-Joseph University, Beirut, Lebanon.
Medical Faculty, Sofia University St Kliment Ohridski, Kozyak Str., Sofia, , Bulgaria.
Department of Rheumatology, Green Life Medical College, Dhaka, Bangladesh.
Department of Rheumatology, Clinic of Rheumatology, University Hospital "St Ivan Rilski", Medical University-Sofia, Bulgaria.
Department of Internal Medicine, Rheumatology, Diabetology, Geriatrics and Clinical Immunology, Pomeranian Medical University in Szczecin, ul Unii Lubelskiej , Szczecin, -, Poland.
Rheumatology Unit, Department of Internal Medicine, Hospital Sultanah Bahiyah, Alor Setar, Malaysia.
Department of Internal Medicine, General Hospital, National Medical Center "La Raza", Instituto Mexicano del Seguro Social, Av. Jacaranda S/N, Col. La Raza, Del. Azcapotzalco, Mexico City, C.P. , Mexico.
Rheumatology Unit, Dipartimento di Medicine Interna e Terapia Medica, Università degli studi di Pavia, Pavia, Lombardy, Italy.
National Center for Rheumatic Diseases (NCRD), Ratopul, Kathmandu, Nepal.
Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, -- Sendagi, Bunkyo-ku, Tokyo, -, Japan.
Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, .
Medizinische Klinik -Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg , Erlangen, , Deutschland.
Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA.
Rheumatology, Medical Care & Research, Centro Medico Pensiones Hospital, Instituto Mexicano del Seguro Social Delegación Yucatán, Yucatán, Mexcio.
Rheumatologist and Clinical Investigator, Interstitial Lung Disease and Rheumatology Unit, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico.
Department of Internal Medicine, Section of rheumatology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
Rheumatology Unit, Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, Korle-Bu, Accra, Ghana.
General Director, Reference Center for Osteoporosis, Rheumatology and Dermatology, Pontifica Universidad Javeriana Cali, Colombia.
Department of Medicine, Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand.
Department of Medicine, Hospital Universidad del Norte, Barranquilla, Atlantico, Colombia.
Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, , Australia.
Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Centre for Rheumatic Diseases, King's College London, London, UK.
Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre The University of Manchester, Manchester, UK.
Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK.
Abstract summary
The presence of comorbidities can substantially affect patients' quality of life, but data regarding their impact on idiopathic inflammatory myopathies (IIMs) are limited.We examined the prevalence of comorbidities in IIM patients, other autoimmune rheumatic diseases (oAIRDs), and healthy controls (HCs), using data from the self-reported COVAD-2 survey. We defined Basic Multimorbidity (BM) as the presence of ≥ 2 non-rheumatic chronic conditions and Complex Multimorbidity (CM) as the presence of ≥ 3 non-rheumatic chronic conditions affecting ≥3 organ systems. Hierarchical Clustering on Principal Components was performed for grouping.Among the COVAD respondents, 1558 IIMs, 4591 oAIRDs, and 3652 HCs were analysed. IIMs exhibited a high burden of comorbidities (OR: 1.62 vs oAIRDs and 2.95 vs HCs, p< 0.01), BM (OR 1.66 vs oAIRDs and 3.52 vs HCs, p< 0.01), CM (OR: 1.69 vs AIRDs and 6.23 vs HCs, p< 0.01), and mental health disorders (MHDs) (OR 1.33 vs oAIRDs and 2.63 vs HCs, p< 0.01). Among the IIM patients, those with comorbidities or MHDs had lower PROMIS Global Physical (PGP), PROMIS Global Mental (PGM), and PROMIS Physical Function (SF10) scores, and higher fatigue (F4a) scores (all p< 0.001). PGP, PGM, SF10a and F4a were influenced by age, active disease, BM, and MHDs. Four distinct clusters were identified among the IIMs according to comorbidities and PROMIS scores.Patients with IIMs have a higher burden of comorbidities that influence physical and mental health, identifiable as clinical clusters for optimized and holistic management approaches.
Authors & Co-authors:
Fornaro Marco M
Venerito Vincenzo V
Pellico Maria Rosa MR
Iannone Florenzo F
Joshi Mrudula M
Chen Yi-Ming YM
Tan Ai Lyn AL
Saha Sreoshy S
Chatterjee Tulika T
Agarwal Vishwesh V
Shinjo Samuel Katsuyuki SK
Hoff Leonardo Santos LS
Kadam Esha E
Ziade Nelly N
Velikova Tsvetelina T
Hasan A T M Tanveer ATMT
Shumnalieva Russka R
Milchert Marcin M
Tan Chou Luan CL
Edgar Gracia-Ramos Abraham A
Cavagna Lorenzo L
Vaidya Binit B
Kuwana Masataka M
Sazliyana Shaharir Syahrul S
Knitza Johannes J
Makol Ashima A
Zamora Tehozol Erick Adrian EA
Rojas Serrano Jorge J
Halabi Hussein H
Dey Dzifa D
Toro Gutierrez Carlos Enrique CE
Akawatcharangura Goo Phonpen P
Caballero Uribe Carlo Vinicio CV
Distler Oliver O
Katchamart Wanruchada W
Day Jessica J
Parodis Ioannis I
Nikiphorou Elena E
Chinoy Hector H
Agarwal Vikas V
Gupta Latika L
Study Outcome
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