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Damage extent and predictors in adult and juvenile dermatomyositis and polymyositis as determined with the myositis damage index.

Publication ,  Journal Article
Rider, LG; Lachenbruch, PA; Monroe, JB; Ravelli, A; Cabalar, I; Feldman, BM; Villalba, ML; Myones, BL; Pachman, LM; Rennebohm, RM; Reed, AM ...
Published in: Arthritis Rheum
November 2009

OBJECTIVE: We undertook this study to validate the Myositis Damage Index (MDI) in juvenile and adult myositis, to describe the degree and types of damage and to develop predictors of damage. METHODS: Retrospective MDI evaluations and prospective assessment of disease activity and illness features were conducted. Patients with juvenile-onset disease (n = 143) were evaluated a median of 18 months after diagnosis; 135 patients were assessed 7-9 months later, and 121 were last assessed a median of 82 months after diagnosis. Ninety-six patients with adult-onset dermatomyositis or polymyositis had a baseline assessment a median of 30 months after diagnosis; 77 patients had a 6-month followup evaluation, and 55 had a final assessment a median of 60 months after diagnosis. RESULTS: Damage was present in 79% of juvenile patients and in 97% of adult patients. In juveniles, scarring, contractures, persistent weakness, muscle dysfunction, and calcinosis were most frequent (23-30%) at the last evaluation. In adults, muscle atrophy, muscle dysfunction, and muscle weakness were most frequent (74-84%). MDI severity correlated with physician-assessed global damage, serum creatinine, and muscle atrophy on magnetic resonance imaging, and in juveniles also with functional disability and weakness. MDI damage scores and frequency were highest in patients with a chronic illness course and in adult patients who died. Predictors of damage included functional disability, duration of active disease, disease severity at diagnosis, physician-assessed global disease activity, and illness features, including ulcerations in children and pericarditis in adults. CONCLUSION: Damage is common in myositis after a median duration of 5 years in patients with adult-onset disease and 6.8 years in patients with juvenile-onset disease. The MDI has good content, construct, and predictive validity in juvenile and adult myositis.

Duke Scholars

Published In

Arthritis Rheum

DOI

ISSN

0004-3591

Publication Date

November 2009

Volume

60

Issue

11

Start / End Page

3425 / 3435

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Retrospective Studies
  • Reproducibility of Results
  • Predictive Value of Tests
  • Polymyositis
  • Myositis
  • Muscular Atrophy
  • Muscle Weakness
  • Middle Aged
  • Male
 

Citation

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ICMJE
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Rider, L. G., Lachenbruch, P. A., Monroe, J. B., Ravelli, A., Cabalar, I., Feldman, B. M., … IMACS Group, . (2009). Damage extent and predictors in adult and juvenile dermatomyositis and polymyositis as determined with the myositis damage index. Arthritis Rheum, 60(11), 3425–3435. https://doi.org/10.1002/art.24904
Rider, Lisa G., Peter A. Lachenbruch, Jason B. Monroe, Angelo Ravelli, Imelda Cabalar, Brian M. Feldman, Maria L. Villalba, et al. “Damage extent and predictors in adult and juvenile dermatomyositis and polymyositis as determined with the myositis damage index.Arthritis Rheum 60, no. 11 (November 2009): 3425–35. https://doi.org/10.1002/art.24904.
Rider LG, Lachenbruch PA, Monroe JB, Ravelli A, Cabalar I, Feldman BM, et al. Damage extent and predictors in adult and juvenile dermatomyositis and polymyositis as determined with the myositis damage index. Arthritis Rheum. 2009 Nov;60(11):3425–35.
Rider, Lisa G., et al. “Damage extent and predictors in adult and juvenile dermatomyositis and polymyositis as determined with the myositis damage index.Arthritis Rheum, vol. 60, no. 11, Nov. 2009, pp. 3425–35. Pubmed, doi:10.1002/art.24904.
Rider LG, Lachenbruch PA, Monroe JB, Ravelli A, Cabalar I, Feldman BM, Villalba ML, Myones BL, Pachman LM, Rennebohm RM, Reed AM, Miller FW, IMACS Group. Damage extent and predictors in adult and juvenile dermatomyositis and polymyositis as determined with the myositis damage index. Arthritis Rheum. 2009 Nov;60(11):3425–3435.
Journal cover image

Published In

Arthritis Rheum

DOI

ISSN

0004-3591

Publication Date

November 2009

Volume

60

Issue

11

Start / End Page

3425 / 3435

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Retrospective Studies
  • Reproducibility of Results
  • Predictive Value of Tests
  • Polymyositis
  • Myositis
  • Muscular Atrophy
  • Muscle Weakness
  • Middle Aged
  • Male