The impact of multimorbidity on Quality of Life in inflammatory myopathies: A cluster analysis from the COVAD dataset
Authors: Fornaro Marco , Venerito Vincenzo , Pellico Maria Rosa , Iannone Florenzo , Joshi Mrudula , Chen Yi-Ming , Tan Ai Lyn , Saha Sreoshy , Chatterjee Tulika , Agarwal Vishwesh , Shinjo Samuel Katsuyuki , Hoff Leonardo Santos , Kadam Esha , Ziade Nelly , Velikova Tsvetelina , Hasan A T M Tanveer , Shumnalieva Russka , Milchert Marcin , Tan Chou Luan , Gracia-Ramos Abraham Edgar , Cavagna Lorenzo , Vaidya Binit , Kuwana Masataka , Shaharir Syahrul Sazliyana , Knitza Johannes , Makol Ashima , Tehozol Erick Adrian Zamora , Serrano Jorge Rojas , Halabi Hussein , Dey Dzifa , Toro-Gutiérrez Carlos Enrique , Goo Phonpen Akarawatcharangura , Caballero-Uribe Carlo V , Distler Oliver , Katchamart Wanruchada , Day Jessica , Parodis Ioannis , Nikiphorou Elena , Chinoy Hector , Agarwal Vikas , Gupta Latika ,   CoVAD Study Group, Sen Parikshit , Javaid Mahnoor , Andreoli Laura , Lini Daniele , Schreiber Karen , Nune Arvind , Tan Ai Lyn , Patel Aarat , Pauling John D , Wincup Chris , Barman Bhupen , García-De La Torre Ignacio , Colunga-Pedraza Iris J , Merayo-Chalico Javier , Chibuzo Okwara Celestine , El Kibbi Lina , Lilleker James B , Salim Babur , Gheita Tamer , Saavedra Miguel A , Griger Zoltán , Kardes Sinan , Vince Melinda Nagy , Singh Yogesh Preet , Ranjan Rajiv , Jain Avinash , Pandya Sapan C , Pilania Rakesh Kumar , Sharma Aman , M Manesh Manoj , Gupta Vikas , Kavadichanda Chengappa G , Patro Pradeepta Sekhar , Ajmani Sajal , Phatak Sanat , Goswami Rudra Prosad , Chowdhury Abhra Chandra , Mathew Ashish Jacob , Shenoy Padnamabha , Asranna Ajay , Bommakanti Keerthi Talari , Shukla Anuj , Pande Arunkumar R , Chandwar Kunal , Ghodke Akanksha , Boro Hiya , Fazal Zoha Zahid , Vaidya Binit , Cansu Döndü Üsküdar , Yıldırım Reşit , Gasparyan Armen Yuri , Del Papa Nicoletta , Sambataro Gianluca , Fabiola Atzeni , Govoni Marcello , Parisi Simone , Bocci Elena Bartoloni , Sebastiani Gian Domenico , Fusaro Enrico , Sebastiani Marco , Quartuccio Luca , Franceschini Franco , Sainaghi Pier Paolo , Orsolini Giovanni , De Angelis Rossella , Danieli Maria Giovanna , Grignaschi Silvia , Giollo Alessandro , Alunno Alessia , Traboco Lisa S , Wibowo Suryo Anggoro Kusumo , Loarce-Martos Jesús , Prieto-González Sergio , Gonzalez Raquel Aranega , Yoshida Akira , Nakashima Ran , Sato Shinji , Kimura Naoki , Kaneko Yuko , Gono Takahisa , Tomaras Stylianos , Proft Fabian Nikolai , Holzer Marie-Therese , Gromova Margarita Aleksandrovna , Aharonov Or , Griger Zoltán , Hmamouchi Ihsane , El bouchti Imane , Baba Zineb , Giannini Margherita , Maurier François , Campagne Julien , Meyer Alain , Langguth Daman , Limaye Vidya , Needham Merrilee , Srivastav Nilesh , Hudson Marie , Landon-Cardinal Océane , Zuleta Wilmer Gerardo Rojas , Arbeláez Álvaro , Cajas Javier , Silva José António Pereira , Fonseca João Eurico , Zimba Olena , Ima-Edomwonyi Uyi , Dedeke Ibukunoluwa , Airenakho Emorinken , Madu Nwankwo Henry , Yerima Abubakar , Olaosebikan Hakeem , Becky A , Koussougbo Oruma Devi , Palalane Elisa , So Ho , Ugarte-Gil Manuel Francisco , Chinchay Lyn , Bernaola José Proaño , Pimentel Victorio , Fathi Hanan Mohammed , Mohammed Reem Hamdy A , Harifi Ghita , Fuentes-Silva Yurilís , Cabriza Karoll , Losanto Jonathan , Colaman Nelly , Cachafeiro-Vilar Antonio , Bautista Generoso Guerra , Ho Enrique Julio Giraldo , González Raúl , Nunez Lilith Stange , M Cristian Vergara , Báez Jossiell Then , Alonzo Hugo , Pastelin Carlos Benito Santiago , Salinas Rodrigo García , Obiols Alejandro Quiñónez , Chávez Nilmo , Ordóñez Andrea Bran , Argueta Sandra , Llerena Gil Alberto Reyes , Sierra-Zorita Radames , Arrieta Dina , Hidalgo Eduardo Romero , Saenz Ricardo , M Idania Escalante , Morales Roberto , Calapaqui Wendy , Quezada Ivonne , Arredondo Gabriela 
Published: September 2024

Abstract

Objective
The presence of comorbidities can substantially affect patients’ quality of life, but data regarding their impact on idiopathic inflammatory myopathies (IIMs) are limited.

Methods
We examined the prevalence of comorbidities in IIM patients, other autoimmune rheumatic diseases (oAIRDs) and healthy controls (HCs), using data from the self-reported COVAD-2 survey. We defined basic multimorbidity (BM) as the presence of ≥2 non-rheumatic chronic conditions and complex multimorbidity (CM) as the presence of ≥3 non-rheumatic chronic conditions affecting ≥3 organ systems. Hierarchical clustering on principal components was performed for grouping.

Results
Among the COVAD respondents, 1558 IIMs, 4591 oAIRDs and 3652 HCs were analysed. IIMs exhibited a high burden of comorbidities (odds ratio [OR]: 1.62 vs oAIRDs and 2.95 vs HCs, P &lt; 0.01), BM (OR: 1.66 vs oAIRDs and 3.52 vs HCs, P &lt; 0.01), CM (OR: 1.69 vs AIRDs and 6.23 vs HCs, P &lt; 0.01) and mental health disorders (MHDs) (OR: 1.33 vs oAIRDs and 2.63 vs HCs, P &lt; 0.01). Among the IIM patients, those with comorbidities or MHDs had lower PROMIS Global Physical (PGP), PROMIS Global Mental (PGM), and PROMIS Physical Function (SF10) scores, and higher fatigue (F4a) scores (all P &lt; 0.001). PGP, PGM, SF10a and F4a were influenced by age, active disease, BM and MHDs. Four distinct clusters were identified among the IIMs according to comorbidities and PROMIS scores.

Conclusion
Patients with IIMs have a higher burden of comorbidities that influence physical and mental health, identifiable as clinical clusters for optimized and holistic management approaches.