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Abstract Number: 1160

Short Form-36 Psychometric Properties in Idiopathic Inflammatory Myopathies: Reliability, Validity and Responsiveness

shiri keret1, Anushka Aggarwal2, Maha Almackenzie3, Tanya Chandra4, Raisa Silva5, Eugenia Gkiaouraki6, Nantakarn Pongtarakulpanit7, shreya Sriram6, Chester Oddis7 and Rohit Aggarwal8, 1Rheumatology unit, Bnai-Zion medical center and the faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel., Atlit, Israel, 2Department of Rheumatology, Indraprastha Apollo Hospital, New delhi, NY, 3Division of Rheumatology, Department of Medicine, Medical Cities of the Ministry of the Interior Riyadh, Saudi Arabia, Arlington, VA, 4University of Pittsburgh Medical Center, Pittsburgh, PA, 5Internal medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, 6Division of Rheumatology and Clinical Immunology, University of Pittsburgh Medical Center, Pittsburgh, PA, 7Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA, 8Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA, USA, Pittsburgh, PA

Meeting: ACR Convergence 2024

Keywords: dermatomyositis, Disability, Myopathies, quality of care, SF36

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Session Information

Date: Sunday, November 17, 2024

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

Session Type: Poster Session B

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

Background/Purpose: The quality of life, as measured by the Short Form-36 (SF-36), is reduced in patients with idiopathic inflammatory myopathies (IIM). Although endorsed by the International Myositis Assessment and Clinical Studies Group (IMACS) for evaluating myositis patients, SF-36 has not been fully validated in IIM. This study aimed to investigate the psychometric properties of the SF-36 in a large cohort of IIM patients.

Methods: Patients fulfilling the EULAR/ACR classification criteria were enrolled in the study utilizing a database of patients enrolled in two clinical trials (Tocilizumab in Myositis and Acthar in Myositis) and one prospective observational study (PAMPRO). The SF-36 evaluates eight subdomains: physical function, bodily pain, physical health limitations, emotional problems, emotional well-being, social functioning, energy/fatigue, and general health, along with physical health summary score (PCS) and a mental health summary score (MCS). Data collection included demographic and clinical parameters, encompassing all myositis core set measures (CSMs): MMT-8, patient and physician global assessments, HAQ, muscle enzymes, and extra-muscular disease activity scores.

Results: One hundred and five IIM patients were included (44% dermatomyositis, 30% anti-synthetase syndrome, 18% polymyositis, 8% necrotizing myopathy), mean age of 52.31 ± 13.62, 64% females and 85% Caucasians. Most SF-36 domain and summary scores were significantly lower compared to the general population [1] (Table 1). SF-36 components were similar among IIM sub-types, except for significantly lower physical function scores in necrotizing myopathy patients (p=0.02). No association was found between SF-36 scores and age, sex, or race. All SF-36 domain scores were significantly lower in patients with abnormal MMT, active disease by physician global, and increased disability by HAQ score ≥ 0.5.
SF-36 PCS and MCS components demonstrated good test-retest reliability at 1 month (r=0.874 p< 0.001 and r=0.731 p< 0.001, respectively). Strong associations of PCS and MCS with other CSMs were demonstrated, including patient and physician-global assessments, HAQ score, and extra-muscular disease activity, indicating good validity. Longitudinal correlations were significant between PCS and MCS for all CSMs, except for MMT-8 (Table 2). SF-36 illustrated significant and concordant change with myositis response criteria and physician/patient assessments of change, with a large effect size (Table 3). The clinically important difference (CID) of SF-36 PCS score using the anchors patient/physician-reported change at 6 months and the 2016 ACR/EULAR myositis response criteria were 8.2, 6.5, and 5.8, respectively. The CID of SF-36 MCS score using the same anchors were 8.8, 8.1, and 8.9, respectively.

Conclusion: SF-36 demonstrates good reliability, validity and responsiveness in a large cohort of IIM patients. This important patient-reported outcome should be utilized for assessing health-related quality of life in clinical practice and trials.

References:

1. Hopman WM, et al. Canadian normative data for the SF-36 health survey. CMAJ. 2000;163(3):265-71.

Supporting image 1

Table 1-Patients characteristics, and SF_36 domain scores compared to the general population:

Supporting image 2

Table 2: The correlation of SF_36 scores (physical and mental health summary scores) with core set measures during the follow-up period, using a linear mixed model, adjusted for sex, age, and race.

Supporting image 3

Table 3: Baseline, follow-up, and change over 6 months [mean (SD)], and effect size of SF_36, in each ACR/EULAR myositis response criteria 2016 (total improvement score), physician-reported change, and patient-reported change groups.


Disclosures: s. keret: None; A. Aggarwal: None; M. Almackenzie: None; T. Chandra: None; R. Silva: None; E. Gkiaouraki: None; N. Pongtarakulpanit: None; s. Sriram: 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:

keret s, Aggarwal A, Almackenzie M, Chandra T, Silva R, Gkiaouraki E, Pongtarakulpanit N, Sriram s, Oddis C, Aggarwal R. Short Form-36 Psychometric Properties in Idiopathic Inflammatory Myopathies: Reliability, Validity and Responsiveness [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/short-form-36-psychometric-properties-in-idiopathic-inflammatory-myopathies-reliability-validity-and-responsiveness/. Accessed .
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