To assess the long-term prognosis of dermatomyositis and polymyositis.
69 patients with dermatomyositis or polymyositis were selected according to the diagnostic criteria of Bohan and Peter and were followed up for a minimum of 6.3 years (for surviving patients) (mean 11.6 years).
Clinical and biological features, and pulmonary and muscle parameters were considered as prognostic factors for death.
Functional disability was assessed using a 4-stage grading system.
30 deaths (43.5%) occurred, mainly due to cardiovascular (8), pulmonary (8), carcinomatous (5) and iatrogenic complications (5).
Survival rates were 82.6% at 1 year, 73.9% at 2,66. 7% at 5 and 55.4% at 9. Significant prognostic factors for death (Cox model with time-dependent covariates) were old age (p<0.0001) dysphonia (p<0. 001), pulmonary interstitial fibrosis (p<0.02), absence of myalgia (p<0.02), absence of dysphagia (p<0.02) and asthenia-anorexia (p<0.05).
Dermatomyositis and polymyositis subgroups had slightly different significant prognostic factors for death : old age, cancer, pulmonary interstitial fibrosis and asthenia-anorexia for dermatomomyositis ; old age, failure to improve muscle strength in response to treatment after one month, and the absence of myalgia as presenting symptom for polymyositis.
At the end of the follow-up, 33/39 surviving patients (84. (...)
Mots-clés Pascal : Dermatomyosite, Homme, Etude comparative, Polymyosite, Pronostic, Survie, Long terme, Facteur risque, Mortalité, Epidémiologie, Loire Atlantique, Pays de Loire, France, Europe, Peau pathologie, Tissu conjonctif pathologie, Maladie autoimmune, Immunopathologie, Muscle strié pathologie, Maladie système
Mots-clés Pascal anglais : Dermatomyositis, Human, Comparative study, Polymyositis, Prognosis, Survival, Long term, Risk factor, Mortality, Epidemiology, Loire-Atlantique, Pays de Loire, France, Europe, Skin disease, Connective tissue disease, Autoimmune disease, Immunopathology, Striated muscle disease, Systemic disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0316736
Code Inist : 002B07. Création : 10/04/1997.