ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1284

Idiopathic Inflammatory Myopathies: Are Muscle Biopsies Still Needed?

Belén Virasoro1, Ramiro Gomez 2, Andrea Braillard Poccard 3, Dafne Capelusnik 4, Emilce Schneeberger 5, Silvia Papasidero 6, Juan Bande 6, Malena Viola 7, Maria de la Vega 8, Carolina Costi 9, Mercedes Garcia 10, Cecilia Asnal 11, Ana Cappuccio 12, Demelza Yucra 13, Linda Vergel Orduz 14, Natalia Tamborenea 15, Mariano Rivero 16, Amelia Granel 17, Carolina Segura Escobar 16, Marina Dalpiaz 15 and Cecilia Pisoni 18, 1CEMIC, buenos aires, Buenos Aires, Argentina, 2Hospital de Clínicas José de San Martín, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina, 3Hospital de Clínicas José de San Martin, Buenos Aires, Buenos Aires, Argentina, 4Instituto de Rehabilitacion Psicofisica, CABA, Ciudad Autonoma de Buenos Aires, Argentina, 5Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina, 6Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina, 7Hospital Argerich, Argentina, Buenos Aires, Argentina, 8CEIM Investigaciones Medicas, Buenos Aires, Argentina, 9Hospital General “San Martín” de la Plata, La Plata, Buenos Aires, Argentina, 10Hospital San Martín, La Plata, Argentina, 11Instituto Centenario, Buenos Aires, Buenos Aires, Argentina, 12Hospital Francés, Buenos Aires, Buenos Aires, Argentina, 13Sanatorio Güemes, Buenos Aires, Buenos Aires, Argentina, 14Sanatorio Gúemes, Buenos Aires, Buenos Aires, Argentina, 15Hospital Rivadavia, Buenos Aires, Buenos Aires, Argentina, 16Hospital Británico, Buenos Aires, Buenos Aires, Argentina, 17Hospital San Roque,Gonnet,La Plata,Buenos Aires.Argentina, La Plata, Buenos Aires, Argentina, 18Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: ,

Session Information

Date: Monday, November 11, 2019

Title: Muscle Biology, Myositis & Myopathies Poster II

Session Type: Poster Session (Monday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Inflammatory myopathies (IM) are a heterogeneous group of diseases characterized by muscle inflammation. In Argentina, there are few pathologists specialized in muscle biopsies and for this reason, there are limitations to perform good quality biopsies.

The objectives of this study are to estimate the frequency of muscle biopsy in patients with IM belonging to Argentinean Society of Rheumatology database, identify the variables associated with its performance and to apply the new EULAR-ACR criteria to the subgroup of patients with biopsy.

Methods: 179 patients with IM were included. Demographic, clinical, laboratory, images and treatment characteristics were collected from medical records.

The muscle biopsy information was obtained from the pathology report of each participating hospital. Therefore, there was no standardization in the report.

To analyze differences between the groups, Chi square was performed for categorical variables and T test or Mann Whitney for continuous variables according to their distribution. Logistic regression analysis was performed for the analysis of variables associated with performing a muscle biopsy.

Results: Table 1 describes clinical characteristics of the cohort. The frequency of muscle biopsies in the cohort was 58 (32%). Table 2 shows variables associated to not having muscle biopsy performed. 

In the logistic regression analysis, the presence of positive antibodies OR 0.21 (CI 95% 0.05- 0.99) and heliotrope rash 0.11 (CI 95% 0.02 to 0.75) were independently associated with NOT performing biopsy.

The complete biopsy report was available in 37 of 52 patients who undergone biopsy. In those patients we applied the EULAR-ACR criteria for inflammatory myopathies with and without biopsy(1).

Conclusion: Muscle biopsy was performed in only one third of patients with IM from our cohort. Patients with myositis-specific antibodies and heliotrope rash were biopsied less frequently. If criteria without biopsy are applied to patients with biopsy most of them will fulfill criteria. Given the difficulties to obtain a good quality muscle biopsy, we propose to only perform muscle biopsy to those patients who do not fulfill non biopsy EULAR-ACR criteria.

References:

  1. Lundberg IE, Tjärnlund A, Bottai M, Werth VP, Pilkington C, Visser M De, et al. 2017 European League Against Rheumatism / American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Ann Rheum Dis. 2017;69(12):2271–82.

Table 1. Clinical characteristics of the cohort.

Table 2. Variables associated to not having muscle biopsy performed.

Disclosure: B. Virasoro, None; R. Gomez, None; A. Braillard Poccard, None; D. Capelusnik, None; E. Schneeberger, None; S. Papasidero, None; J. Bande, None; M. Viola, None; M. de la Vega, AbbVie, 8, BMS, 8, Janssen, 8, Lilly, 8, Pfizer, 5, 8, Raffo, 5, 8, Roche, 9, Sanofi, 5, 8; C. Costi, None; M. Garcia, None; C. Asnal, None; A. Cappuccio, None; D. Yucra, None; L. Vergel Orduz, None; N. Tamborenea, None; M. Rivero, None; A. Granel, None; C. Segura Escobar, None; M. Dalpiaz, None; C. Pisoni, None.

To cite this abstract in AMA style:

Virasoro B, Gomez R, Braillard Poccard A, Capelusnik D, Schneeberger E, Papasidero S, Bande J, Viola M, de la Vega M, Costi C, Garcia M, Asnal C, Cappuccio A, Yucra D, Vergel Orduz L, Tamborenea N, Rivero M, Granel A, Segura Escobar C, Dalpiaz M, Pisoni C. Idiopathic Inflammatory Myopathies: Are Muscle Biopsies Still Needed? [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/idiopathic-inflammatory-myopathies-are-muscle-biopsies-still-needed/. Accessed .

« Back to 2019 ACR/ARP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/idiopathic-inflammatory-myopathies-are-muscle-biopsies-still-needed/