An Investigation Of Quality Of Life And Work Diability In Idiopathic Inflammatory Myositis

Background:Idiopathic inflammatory myositis(IIM)is a group of systemic autoimmune diseases with various clinical manifestations,including polymyositis,dermatomyositis,amyotrophic dermatomyositis,immune-mediated necrotizing myopathy,inclusion body myositis and overlap syndrome.IIM can affect the patients’ quality of life and daily work efficiency,so far there is no related research in China.Objective:To evaluate the quality of life and the working ability of IIM patients,and to analysis the correlationship with the disease type,disease burden and the disease activity.Methods:130 IIM patients presented in the outpatient clinic of department of Rheumatology,Peking Union Medical College Hospital from May 2012 to April 2019.The clinical manifestations,laboratory results,disease activity scores and other disease-related information of the patients were recorded in detail.EQ-5D and WPAI questionnaires were used to evaluate the health-related quality of life and work disability,the correlation analysis was conducted with disease activity.In addition,from April 2019 to August 2019,21 patients in the outpatient clinic of department of Rheumatology,Hong Kong University-Shen zhen Hospital,were scored by Short Form-36(SF-36)scale and compared with healthy control group.Results:Basic data statistics:130 IIM patients came from the rheumatology department of PUMCH,including DM(n=79),PM(n=17),ADM(n=32),IMNM(n-1)and overlap syndrome(n=1).According to the presence of Interstitial lung disease(ILD),they were divided into ILD group(n=57)and non-ILD group(n=73).According to whether having work,they were divided into working group(n=31)and non-working group(n=99).In terms of EQ-5D scale,it was found that there was no significant difference between DM and PM subgroups.There was no significant difference between ILD group and non-ILD group either.There was a significant positive correlation between EQ-5D value score and Manual Muscle Testing-8(MMT-8)(r=0.569,p<0.01).There was a significant negative correlation between EQ-5D value score and myositis activity(r=-0.456,p<0.01).There was a significant negative correlation between EQ-5D value score and MYOACT-muscle score(r=0.624,p<0.01).There was a significant negative correlation between EQ-5D value score and MYOACT-global score(r=0.513,p<0.01).There was a significant negative correlation between EQ-5D value score and patient global activity(r=0.644,p<0.01).There is no correlation between EQ-5D value score and MDI-global score.Of the 31 patients,the presenteeism was 13.23%,the absenteeism was 9.79%,over all work impairment and activity impairment was 18.44%、13.23%respectively.Presenteeism is positively correlated with patient global activity(r=0.600,P<0.01),overall work impairment is positively correlated with patient global activity(r=0.480,P<0.01),activity impairment is positively correlated with MYOACT-muscle score(r=0.397,P<0.01).With regards to the scores of SF-36,physical function(PF),role functioning(RP),general health(GH),vitality(VT),social function(SF),role emotion(RE),and health transition(HT)were lower than those of the control group,while mental health(MH)and body pain(BP)were not.Conclusions:The work ability and quality of life of IIM patients decrease with different degrees,and some of them have significant correlation with disease activity.There is no significant difference between DM and PM,neither the ILD and non-ILD groups.