Despite Low Disease Activity Patients with Poly- and Dermatomyositis Perceive Activity Limitation, Reduced Grip Force and Quality of Life Longitudinally

Malin Regardt¹, Marie-Louise Schult², Ingrid E. Lundberg³ and Elisabet MB Welin Henriksson⁴, ¹Department of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden, ²Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet., Stockholm, Sweden, ³Rheumatology Unit, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden, ⁴Medicine, Karolinska Institutet Rheum, Stockholm, Sweden

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: activities of daily living (ADL), grip strength, longitudinal studies, polymyositis/dermatomyositis (PM/DM) and quality of life

Session Information

Title: Rehabilitation Sciences

Session Type: Abstract Submissions (ARHP)

Background/Purpose: Polymyositis (PM) and dermatomyositis (DM) are characterized by proximal muscle weakness. A recent study has shown that patients with PM and DM have reduced grip force compared to reference values. Although patients with PM/DM respond with clinical improvement to treatment several develop a sustained disability. Clinical data from most of the patients with PM and DM in Sweden are registered annually in the Swedish Myositis Network (SWEMYONET) registry. The aim of this study was to investigate how grip force, activity limitation and health related quality of life (HRQoL) change over time in a cohort of patients with PM/DM.

Methods: A multi-center longitudinal registry study following patients from disease onset and to 1, 2, 3, 4, 5, and 6 years follow-ups. Data were collected from the SWEMYONET registry on patients with PM/DM that had values on either grip force using Grippit, activity limitation measured by Myositis Activities Profile (MAP) or HRQoL measured with Short Form-36 (SF-36) on at least one time-point between disease onset and the 6 years follow-up during the years 2003-2012. A total of 88 patients were included (53 with PM (33 women and 20 men) and 35 with DM (19 women and 16 men)). Median age for the cohort at disease onset was 59.5 years. Disease activity was measured by Physician Global Assessment of disease activity (PGA). Patients were treated with conventional immunosuppressive treatment according to the choice of the treating physician.

Results: Both women and men had reduced grip force from disease onset and over time (compared to reference values), women up to 4 years follow-up from disease onset in right and left hand (p<0.02) and men up to 4 years follow-up in the right hand and 3 years in the left hand (p<0.05). At disease onset, both women and men rated their activities as moderately difficult to perform. Over time women improved at some time-points from disease onset and at the most to 3 years in all except two sub-groups of MAP (avoid overexertion and work/school). Men improved in four out of eight of MAP's sub-groups (movement, moving around, personal care and leisure) at some time-points from disease onset and at the most to 3 years The women had lower values on HRQoL in all eight dimensions of SF-36 compared to reference values from the Swedish population (0.001Conclusion: Even though disease activity decreases over time, patients with PM/DM still have reduced grip force and HRQoL compared to reference values. They also perceive activity limitation over time. The women with PM/DM seem to be more affected over time by the disease than men in grip force, activity limitation and HRQoL.

Disclosure:

M. Regardt,
None;

M. L. Schult,
None;

I. E. Lundberg,
None;

E. M. Welin Henriksson,
None.

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