Infections preceding diagnosis associated with myositis phenotypes in a national patient registry

We investigated the association of antecedent infections with clinical subgroups and phenotypes in the idiopathic inflammatory myopathies (IIMs). Adult IIM patients (362 with dermatomyositis (DM), 250 with polymyositis (PM), and 256 with inclusion body myositis (IBM)) enrolled in a national myositis...

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Vydané v:Clinical and experimental rheumatology Ročník 43; číslo 7; s. 1204
Hlavní autori: Ohnishi, Takuma, Wilkerson, Jesse, Bayat, Nastaran, Farhadi, Payam N, Faiq, Abdullah, Dillon, Charles F, Schiffenbauer, Adam, Parks, Christine G, Brunner, Hermine I, Goldberg, Bob, Miller, Frederick W, Rider, Lisa G
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Italy 01.07.2025
Predmet:
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Dermatomyositis - diagnosis
Dermatomyositis - epidemiology
Female
Humans
Infections - diagnosis
Infections - drug therapy
Infections - epidemiology
Male
Middle Aged
Myositis - diagnosis
Myositis - epidemiology
Odds Ratio
Phenotype
Polymyositis - diagnosis
Polymyositis - epidemiology
Registries
Risk Factors
Time Factors
United States - epidemiology
United States
ISSN:0392-856X
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Shrnutí:We investigated the association of antecedent infections with clinical subgroups and phenotypes in the idiopathic inflammatory myopathies (IIMs). Adult IIM patients (362 with dermatomyositis (DM), 250 with polymyositis (PM), and 256 with inclusion body myositis (IBM)) enrolled in a national myositis patient registry. One hundred thirty-four patients had symptoms of lung disease plus fever and/or arthritis (LD+), and 103 with systemic autoimmune rheumatic disease-associated overlap myositis (OM). Self-reported infections and antibiotic usage within 12 months prior to IIM diagnosis were examined. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated across IIMs. LD+ and OM analyses were performed excluding IBM patients. Infections before IIM diagnosis were more frequent in DM and PM than IBM. Febrile illness and gastroenteritis were more frequent in DM than IBM (OR 2.82 and 3.30, respectively), and in PM than IBM (OR 3.27 and 3.26, respectively). Patients with LD+ and OM had higher odds of reported infections than those without these phenotypes, with pneumonia the most strongly associated infection (OR 5.26 95% CI 2.59-10.71 in LD+, OR 2.75, 95% CI 1.25-6.06 in OM). Antibiotic usage within 1 year before diagnosis did not differ among DM, PM and IBM patients, nor in OM. Antibiotics were used more frequently used in patients with LD+ compared to no LD, but this was attenuated after adjusting for infections. Antecedent infections, particularly respiratory and gastrointestinal infections may contribute to adult IIM phenotypes. Pneumonia showed the strongest association with myositis phenotypes accompanied by frequent lung disease.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0392-856X
DOI:10.55563/clinexprheumatol/tjpsdy