Outcome in patients with idiopathic inflammatory myositis: morbidity and mortality

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Abstract
Objective. To assess the long‐term outcome of a cohort of 46 patients with idiopathic myositis by assessing both health status, as measured by the SF‐36, and cumulative survival probability over a 20‐yr follow‐up period at a single rheumatology centre. Methods and results. Forty‐six patients under long‐term follow‐up from 1978 to 1999 were identified from our database. All patients fulfilled three out of four of the Bohan and Peter criteria for myositis. We excluded those with malignancy‐associated disease and those with inclusion body myositis. Twenty‐three patients (50%) had adult‐onset polymyositis, 14 (30.4%) had adult‐onset dermatomyositis, one had childhood‐onset dermatomyositis and eight (17.4%) had an overlap syndrome (associated with either systemic lupus erythematosus or rheumatoid arthritis). During the course of the disease, seven patients (15.2%) went into full remission, eight (17.4%) had monophasic illness, nine (19.6%) had a relapsing–remitting course, 16 (34.8%) had chronic progressive illness and six (13.04%) died. All patients had significantly lower SF‐36 scores in all aspects of health compared with the general population (P≤0.001). Patients with chronic progressive illness had significantly greater bodily pain (P≤0.05, t‐test) than those with a relapsing–remitting illness, but did not differ in other aspects of health. There was no significant difference in the scores in the different domains of the SF‐36 between the patients with active disease and those with inactive disease (0.05<PConclusion. Patients with myositis report significantly poorer health compared with the general population. Health status and disease activity are important outcome measures in the assessment of patients with myositis.