E059 Identifying the associations between anxiety/depression and disease activity in idiopathic inflammatory myopathy
Authors: Aziz Nadir Z , Oldroyd Alexander , Bozan Francisca , Lyu Xia , Lamb Janine A , Gordon Patrick , Isenberg David A , McHugh Neil , Gunawardena Harsha , Kiely Patrick , Machado Pedro M , Miller James , Tansley Sarah , Bharadwaj Anurag , Laxminarayan Ramasharan , Jordan Natasha , Yee Chee-Seng , Makkuni Damodar , Taylor James , Lanyon Peter C , Ong Voon H , Prabu Athiveeraramapandian , Akil Mohammed , Douglas Karen M , Stathopoulou Eleni , Regan Marian , Chinoy Hector 
Published: April 2024

Abstract

Background/Aims
Idiopathic inflammatory myopathy (IIM) is characterised by myositis, which can impact activities of daily living. The 2022 BSR IIM management guideline recommends assessing/managing factors associated with poor mental wellbeing and quality of life. Research into anxiety and depression associated with IIM is limited. This study aims to investigate associations between anxiety/depression and IIM disease activity.

Methods
The MYOPROSP study recruited UK adults with verified IIM throughout a 36 month period between 2016 and 2020. Patient questionnaires were collected at three, six, and 12 months. Participants completed the EQ-5D-5L questionnaire, which includes a question relating to anxiety and depression with five possible responses: “I am (not/slightly/moderately/severely/extremely) anxious or depressed”. The cohort was divided by response to the EQ-5D-5L anxiety/depression question at the time of recruitment. Disease activity was assessed using International Myositis Assessment & Clinical Studies Group (IMACS) Disease Activity Core Set Measures (see Table 1) and summarised across each EQ-5D-5L anxiety/depression group. The EQ-5D-5L visual analogue scale (VAS) relating to “overall health” (higher values correspond to better health) this value was summarised across each EQ-5D-5L anxiety/depression group. Only participants with complete data at recruitment were included in analysis. One-way ANOVA was performed to determine statistical significance (p &lt; 0.05) of each IMACS Disease Activity Core Set Measure and EQ-5D-5L VAS across anxiety/depression groups.

Results
Complete data on 35 participants (71% female) was collected. All participants reported to have no, slight, or moderate anxiety/depression (i.e. no participant reported severe or extreme anxiety/depression) (Table 1). The “not anxious/depressed” group demonstrated higher EQ-5D VAS values (reflecting better perceived health), shorter disease duration, and higher CK levels, compared to groups with “slight” and “moderate” anxiety/depression. All other investigated variables did not consistently vary across anxiety/depression groups. One-way ANOVA identified that only disease duration and EQ-5D VAS were significantly associated with EQ-5D-5L anxiety/depression group.

Conclusion
Anxiety and depression are associated with longer disease duration and poorer overall health in adults with IIM. These findings suggest that anxiety/depression in adults with IIM may be due to sustained muscle damage and resulting impacts upon activities of daily living and quality of life, rather than disease activity.

Disclosure
N.Z. Aziz: None. A. Oldroyd: None. F. Bozan: None. X. Lyu: None. J.A. Lamb: None. P. Gordon: None. D.A. Isenberg: None. N. McHugh: None. H. Gunawardena: None. P. Kiely: None. P.M. Machado: Consultancies; PMM has received consulting/speaker’s fees from Abbvie, BMS, Celgene, Eli Lilly, Janssen, MSD, Novartis, Orphazyme, Pfizer, Roche and UCB. J. Miller: None. S. Tansley: None. A. Bharadwaj: None. R. Laxminarayan: None. N. Jordan: None. C. Yee: None. D. Makkuni: None. J. Taylor: None. P.C. Lanyon: Consultancies; PCL has received consultancy fees from Pfizer. Grants/research support; PCL has received research grants, speaker fees and conference attendance support from CSL Vifor. V.H. Ong: None. A. Prabu: None. M. Akil: None. K.M. Douglas: None. E. Stathopoulou: None. M. Regan: None. H. Chinoy: None.