ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2062

Performance of the Patient Self-Assessment Tools for Cutaneous Dermatomyositis: Patient CDASI and Rash Mapping

Nantakarn Pongtarakulpanit1, Tanya Chandra1, shiri keret2, Eugenia Gkiaouraki3, Vladimir Liarski1, Dana Ascherman3, Siamak Mogahadam1, Chester Oddis1 and Rohit Aggarwal4, 1Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA, 2Rheumatology unit, Bnai-Zion medical center and the faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel., Atlit, Israel, 3Division of Rheumatology and Clinical Immunology, University of Pittsburgh Medical Center, Pittsburgh, PA, 4Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA, USA, Pittsburgh, PA

Meeting: ACR Convergence 2024

Keywords: ,

Session Information

Date: Monday, November 18, 2024

Title: Muscle Biology, Myositis & Myopathies – Basic & Clinical Science Poster III

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) is a current standard for evaluating rashes in Dermatomyositis (DM). However, there is increasing emphasis on patient-centric outcome measures that incorporate the patient’s perspective of the disease. Moreover, with increasing telemedicine visits, a patient self-assessment of DM rashes is valuable for remote monitoring.  We sought to validate self-assessment tools for rash in DM patients.

Methods: Two tools were utilized: “Patient Cutaneous Dermatomyositis Disease Area and Severity Index (Patient CDASI),” a simplified version of the CDASI modified for the patients, and “Rash mapping.” Rash mapping involves front and back body icons, where patients mark the areas of rashes and rate their severity based on redness. Using Spearman rank correlation coefficients, we validated these tools against the standard in-clinic myositis expert-evaluated CDASI and standard patient-reported outcomes (Skindex, Itch Scale, and Patient global assessment of disease activity-PtGA) completed at the same visit. Active DM skin disease, defined by the physician’s visual analog scale (VAS) ≥ 3, was also assessed by myositis experts.   

Results: 27 DM patients [81.5% female, 96.3% Caucasian; median (IQR) age 50.0 (38.0 – 61.0) years and a median (IQR) disease duration 38.0 (9.5 – 88.0) months] satisfying the ACR/EULAR 2017 classification criteria with 1-2 clinic visits spaced at least 3 months apart were enrolled.  The most common myositis-specific antibody was TIF1-γ (13 patients, 48.1%). Half of the patients had active DM skin disease. The median (IQR) of the standard CDASI activity score was 6.0 (0.0 – 17.0), and the median (IQR) Skindex score was 28.0 (4.0 – 45.0). The Spearman rank correlation coefficients for patient CDASI with the standard CDASI, Skindex, Itch Scale, and PtGA were 0.77, 0.75, 0.67, and 0.79, respectively (p< 0.01 for all). The correlation coefficients for rash mapping with the standard CDASI, Skindex, Itch Scale, and PtGA were 0.84, 0.87, 0.75, and 0.83, respectively (p< 0.01 for all).

Conclusion: Our findings demonstrate the favorable validity of both patient CDASI and patient rash mapping tools for DM patients to self-evaluate their rashes.

Supporting image 1

Table 1. The correlations of Patient Cutaneous Dermatomyositis Disease Area and Severity Index (patient CDASI) and patient rash mapping, with standard in-clinic expert CDASI, Skindex, Itch Scale, and Patient global assessment of disease activity (PtGA)

Supporting image 2

Figure 1. Patient Cutaneous Dermatomyositis Disease Area and Severity Index (patient CDASI). This is a simplified version of the standard CDASI, with patient instructions for identifying different types of dermatomyositis rashes. The scoring system ranges from 0 to 99, with higher scores indicating greater disease severity.

Supporting image 3

Figure 2. Patient Rash Mapping. Rash mapping involves front and back body icons, where patients mark the affected areas and rate the severity of their rashes based on redness. The final score is calculated by summing up the products of the percentage of body surface area involved in each rash, multiplied by the corresponding redness of the rash assessed by the patient (pink = 1, red = 2, dark red = 3).

Disclosures: N. Pongtarakulpanit: None; T. Chandra: None; s. keret: None; E. Gkiaouraki: None; V. Liarski: None; D. Ascherman: None; S. Mogahadam: None; C. Oddis: Abcuro, 5, Alexion, 5, Argenx, 5, Boehringer Ingelheim, 5, CSL Behring, 5, EMD Serono, 5, Janssen, 5, Pfizer, 5, Priovant, 5; R. Aggarwal: Alexion, 2, ANI Pharmaceuticals, 2, Argenx, 2, AstraZeneca, 2, Boehringer-Ingelheim, 2, 5, Bristol-Myers Squibb(BMS), 2, 5, CabalettaBio, 2, Capella Bioscience, 2, Capstanx, 2, Corbus, 2, CSL Behring, 2, EMD Serono, 2, 5, Galapagos, 2, Horizon Therapeutics, 2, I-Cell, 2, Immunovant, 2, Janssen, 1, 2, 5, Kezar, 2, Kyverna, 2, Lilly, 2, Mallinckrodt, 5, Manta Medicines Corporation, 2, Merck, 2, Novartis, 2, Nuvig Therapeutics, 2, Octapharma, 2, Pfizer, 2, 5, Q32, 5, Roivant, 2, Sanofi, 2, Teva, 2.

To cite this abstract in AMA style:

Pongtarakulpanit N, Chandra T, keret s, Gkiaouraki E, Liarski V, Ascherman D, Mogahadam S, Oddis C, Aggarwal R. Performance of the Patient Self-Assessment Tools for Cutaneous Dermatomyositis: Patient CDASI and Rash Mapping [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/performance-of-the-patient-self-assessment-tools-for-cutaneous-dermatomyositis-patient-cdasi-and-rash-mapping/. Accessed .

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