PT  - JOURNAL ARTICLE
AU  - I M Bronner
AU  - M F G van der Meulen
AU  - M de Visser
AU  - S Kalmijn
AU  - W J van Venrooij
AU  - A E Voskuyl
AU  - H J Dinant
AU  - W H J P Linssen
AU  - J H J Wokke
AU  - J E Hoogendijk
TI  - Long-term outcome in polymyositis and dermatomyositis
AID  - 10.1136/ard.2005.045690
DP  - 2006 Nov 01
TA  - Annals of the Rheumatic Diseases
PG  - 1456--1461
VI  - 65
IP  - 11
4099  - http://ard.bmj.com/content/65/11/1456.short
4100  - http://ard.bmj.com/content/65/11/1456.full
SO  - Ann Rheum Dis2006 Nov 01; 65
AB  - Background: Although polymyositis and dermatomyositis are regarded as treatable disorders, prognosis is not well known, as in the literature long-term outcome and prognostic factors vary widely.Aim: To analyse the prognostic outcome factors in polymyositis and adult dermatomyositis.Methods: We determined mortality, clinical outcome (muscle strength, disability, persistent use of drugs and quality of life) and disease course and analysed prognostic outcome factors.Results: Disease-related death occurred in at least 10% of the patients, mainly because of associated cancer and pulmonary complications. Re-examination of 110 patients after a median follow-up of 5 years showed that 20% remained in remission and were off drugs, whereas 80% had a polycyclic or chronic continuous course. The cumulative risk of incident connective tissue disorder in patients with myositis was significantly increased. 65% of the patients had normal strength at follow-up, 34% had no or slight disability, and 16% had normal physical sickness impact profile scores. Muscle weakness was associated with higher age (odds ratio (OR) 3.6; 95% confidence interval (CI) 1.3 to 10.3). Disability was associated with male sex (OR 3.1; 95% CI 1.2 to 7.9). 41% of the patients with a favourable clinical outcome were still using drugs. Jo-1 antibodies predicted the persistent use of drugs (OR 4.4, 95% CI 1.3 to 15.0).Conclusions: Dermatomyositis and polymyositis are serious diseases with a disease-related mortality of at least 10%. In the long term, myositis has a major effect on perceived disability and quality of life, despite the regained muscle strength.