Background: Many studies investigating gender-related differences among patients with Connective Tissue Diseases (CTDs) have found a worse Quality of Life (QoL) in female patients. However few studies have investigated gender differences in Idiopathic Inflammatory Myopathies (IIM) with respect to QoL parameters. Objectives: This work aimed at analysing which demographic or clinical factors mostly impacted on the QoL of men with IIMs. Methods: We retrospectively analyzed the clinical charts of male patients with a diagnosis of IIM according to EULAR/ACR 2017 criteria, followed at the Myositis Clinic of our Unit, collecting epidemiological and clinical data. Patients’ QoL was evaluated through the following patient-reported outcomes (PROs): Short-form 36 (SF36), Hospitality Anxiety and Depression Scale (HADS), Functional Assessment of Chronic Disease Therapy-Fatigue (FACIT-F), Health Assessment Questionnaire (HAQ), Patient Global Assessment (PGA). Statistical analysis was performed using the Mann-Whitney test, t test, Chi-square test, and Fisher’s tests, as appropriate; a value of p<0.05 was considered significant. Results: A total of 61 male patients with a mean age of 65.7±14.89 years and a mean disease duration of 8.5 ±6.5 years were enrolled. The graph shows the distribution of clinical subsets. Among organ involvement, the analysis showed a correlation between dysphagia and higher values of HADS-D (p=0.036) and lower values of VT domain of SF36 (p=0.004), between cardiac involvement and higher values of PGA (p=0.004) and lower values of PF (p=0.048), RE and GH items of SF-36 (p<0.04), between sicca syndrome and higher values of HADS-D (p=0.04), FACIT (p<0.001) and items VT (p=0.0015) and BP of SF-36 (p<0.03). Lower scores at MMT8 correlated with higher values of PGA (p=0.07), HAQ-DI (p<0.001) and lower values of items PF, VT and GH of SF36 (p<0.04); higher scores of CDASI-damage correlated with lower values of SF36-VT (p=0.008). Regarding comorbidities, the obesity indirectly correlated with RP and RE items of SF36 (p<0.001), while hyperuricaemia (HU) directly with HAQ-DI (p=0.08) and indirectly with item PF of SF36 (p=0.033). Considering therapies, a correlation was found among higher cumulative doses of steroids and higher values of item SF of SF36 (p=0.038) and between a history of more than 2 immunosuppressant and lower values of RE item (p=0.02) of SF36. Higher scores of PhGA indirectly correlated with FACIT (p=0.002) and item VT of SF36 (p=0.009). Conclusion: Our data showed a higher risk of depression in men with IIM who presented with dysphagia and sicca syndrome. A history of cardiac involvement or obesity seemed to impact on both physical and psychological functioning; on the contrary, muscle involvement, sicca syndrome, cutaneous damage and HU might predominantly interfere with physical domains; moreover, a more complex therapeutic history could compromise the emotional sphere. Of note, higher amounts of steroids seemed to improve the social functioning of patients. Interestingly, rheumatologists seemed to have a better insight in male patients’ perception of fatigue. Further studies are needed to confirm these results; however, they could help clinicians to typify the compromission of QoL in men with IIM, thus allowing focused interventions to improve their management, aiming at optimizing their outcomes.
AB0263 MALE PERSPECTIVE IN IDIOPATHIC INFLAMMATORY MYOPATHIES: FOCUSING ON QUALITY OF LIFE
Cardelli, C.;
2024-01-01
Abstract
Background: Many studies investigating gender-related differences among patients with Connective Tissue Diseases (CTDs) have found a worse Quality of Life (QoL) in female patients. However few studies have investigated gender differences in Idiopathic Inflammatory Myopathies (IIM) with respect to QoL parameters. Objectives: This work aimed at analysing which demographic or clinical factors mostly impacted on the QoL of men with IIMs. Methods: We retrospectively analyzed the clinical charts of male patients with a diagnosis of IIM according to EULAR/ACR 2017 criteria, followed at the Myositis Clinic of our Unit, collecting epidemiological and clinical data. Patients’ QoL was evaluated through the following patient-reported outcomes (PROs): Short-form 36 (SF36), Hospitality Anxiety and Depression Scale (HADS), Functional Assessment of Chronic Disease Therapy-Fatigue (FACIT-F), Health Assessment Questionnaire (HAQ), Patient Global Assessment (PGA). Statistical analysis was performed using the Mann-Whitney test, t test, Chi-square test, and Fisher’s tests, as appropriate; a value of p<0.05 was considered significant. Results: A total of 61 male patients with a mean age of 65.7±14.89 years and a mean disease duration of 8.5 ±6.5 years were enrolled. The graph shows the distribution of clinical subsets. Among organ involvement, the analysis showed a correlation between dysphagia and higher values of HADS-D (p=0.036) and lower values of VT domain of SF36 (p=0.004), between cardiac involvement and higher values of PGA (p=0.004) and lower values of PF (p=0.048), RE and GH items of SF-36 (p<0.04), between sicca syndrome and higher values of HADS-D (p=0.04), FACIT (p<0.001) and items VT (p=0.0015) and BP of SF-36 (p<0.03). Lower scores at MMT8 correlated with higher values of PGA (p=0.07), HAQ-DI (p<0.001) and lower values of items PF, VT and GH of SF36 (p<0.04); higher scores of CDASI-damage correlated with lower values of SF36-VT (p=0.008). Regarding comorbidities, the obesity indirectly correlated with RP and RE items of SF36 (p<0.001), while hyperuricaemia (HU) directly with HAQ-DI (p=0.08) and indirectly with item PF of SF36 (p=0.033). Considering therapies, a correlation was found among higher cumulative doses of steroids and higher values of item SF of SF36 (p=0.038) and between a history of more than 2 immunosuppressant and lower values of RE item (p=0.02) of SF36. Higher scores of PhGA indirectly correlated with FACIT (p=0.002) and item VT of SF36 (p=0.009). Conclusion: Our data showed a higher risk of depression in men with IIM who presented with dysphagia and sicca syndrome. A history of cardiac involvement or obesity seemed to impact on both physical and psychological functioning; on the contrary, muscle involvement, sicca syndrome, cutaneous damage and HU might predominantly interfere with physical domains; moreover, a more complex therapeutic history could compromise the emotional sphere. Of note, higher amounts of steroids seemed to improve the social functioning of patients. Interestingly, rheumatologists seemed to have a better insight in male patients’ perception of fatigue. Further studies are needed to confirm these results; however, they could help clinicians to typify the compromission of QoL in men with IIM, thus allowing focused interventions to improve their management, aiming at optimizing their outcomes.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
