Background/Purpose: Idiopathic Inflammatory Myopathies (IIM) are chronic diseases often causing disability in patients, associated with both disease activity and damage accrual. These conditions might reduce patients’ working ability, as well as significantly compromise their Quality of Life (QoL). To date, data on the productivity of IIM patients are scarce. The purpose of the study was to evaluate the impact of IIM on productivity both for working and extra-working activities, analysing any correlations with clinical picture, emotional conditions and QoL of patients.

Methods: Consecutive patients diagnosed with IIM (2017 EULAR/ACR criteria) followed at our Myositis Clinic from February to May 2022 were enrolled, collecting demographic and clinical data. The disease activity at the time of the assessment was determined using the specific items from the International Myositis Assessment and Clinical Studies Group. Productivity was assessed by administration of the Work Productivity and Activity Impairment Questionnaire (WPAI). Correlations with the Hospital Anxiety and Depression Scale (HADS) and generic Patient Reported Outcomes (PROs) were also analysed. Results were reported as mean±SD for continuous variables and as percentage for categorical variables. In the statistical analysis, p-value < 0.05 was considered significant.

Results: We included 45 patients (64.4% female, mean age 63.9 ± 14.1 years, mean disease duration 6.3 ± 5.3 years) with the following diagnoses: 24 dermatomyositis (DM, 53.3%), 17 polymyositis (37.9%), 2 amyopathic DM (4.4%), 1 juvenile DM (2.2%), 1 inclusion body myositis (2.2%). The 11 patients (24.4%) who had an occupation had a significantly lower mean age (p=0.008). The absenteeism and presenteeism rates were respectively 13.8% (±31.6) and 30% (±34.6), with an overall work impairment (OWI) of 35.6% (±39.1) and an activity impairment (AI) of 28.2% (±28.9). Patients with sicca symptoms had higher presenteeism rates (p< 0.001). Higher presenteeism and AI correlated positively with Patient Global Assessment (p≤0.002) and negatively with Manual Muscle Testing (p≤0.014); furthermore, AI correlated positively with the Health Assessment Questionnaire score (p< 0.001) and with the risk of anxiety and depression assessed by HADS (p≤0.001) and negatively with all domains related to physical and mental health of the Short-Form 36 (p≤0.002).

Conclusion: The data of our cohort, although preliminary, show significant levels of absenteeism and presenteeism and a significant impairment of both working and non-working productivity of IIM patients, with possible implications on the social cost of IIM. In particular, presenteeism seems to depend on the disease activity, while a reduced extra-work productivity seems to have a significant impact on the psychological sphere; both are associated with a worse QoL. Therefore, a better control of disease activity should be achieved to reduce patients’ disability, thus improving both their physical and emotional functioning.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/productivity-analysis-in-patients-with-idiopathic-inflammatory-myopathies-and-relationship-with-quality-of-life-and-emotional-domain-preliminary-data-from-a-monocentric-cohort/