AB0237 DYSPHONIA AND ANTI-Mi2 ANTIBODIES ARE INDEPENDENTLY ASSOCIATED TO DYSPHAGIA IN INDIVIDUALS OF AFRICAN ANCESTRY WITH IDIOPATHIC INFLAMMATORY MYOPATHIES
Authors: B. Suzon, R. Robert, A. Abel, F. Louis-Sidney, A. Felix, E. Amazan, R. Bellance, A. Parsemain, F. Moinet, I. Coco-Viloin, R. Cougnaud, C. Erere Ngayap, M. Dramé, C. Deligny
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Dysphagia is a life-threatening manifestation of idiopathic inflammatory myopathies (IIM). Some features and associated factors have been reported in individuals of Caucasian and Asian ancestry, but little is known in individuals of African ancestry. <h3>Objectives:</h3> To describe dysphagia during IIM in a population of African ancestry, and to determine associated factors. <h3>Methods:</h3> The medical records of patients with IIM seen between 2004 and 2022 in the only tertiary center of the Caribbean Island of Martinique were reviewed. To be included, patients had to be 18 years of age or older and meet the diagnostic criteria for probable or definite IIM. Dysphagia was retained after evaluation by a speech-language pathologist and/or otolaryngologist, supported by flexible endoscopic swallowing assessment (FEES). The date of diagnosis, clinical and biological characteristics, treatment and disease course were collected and compared between patients suffering from IIM with and without dysphagia. To identify independent associated factors for the onset of dysphagia, a multivariate analysis using a logistic regression model was performed. <h3>Results:</h3> 169 patients with IIM (31 patients with dysphagia and 138 controls without dysphagia) were included. Food aspiration was the most frequent dysphagia symptom (77.4%), and salivary stasis (59.1%) the most frequent finding in FEES. Comparatively, patients with dysphagia had more dermatomyositis (p=0.021), which was diagnosed earlier (p=0.003) than no dysphagia group. Clinical muscular involvement was also more frequent in patients with dysphagia than controls (p&lt;0.001). The multivariate analysis identified anti-Mi2 positivity (OR 4.605, 95%CI [1.386 to 15.661]; p=0.013) and dysphonia (OR 10.119 95%CI [1.549 to 90.560]; p=0.020) as independent factors of dysphagia in IIM. Regarding treatments, patients with dysphagia received more corticosteroid pulses (p=0.010), intravenous immunoglobulins (p&lt;0.001), and methotrexate (p=0.006) than patients without dysphagia. Finally, patients with dysphagia experienced significantly more undernutrition (p=0.002), aspiration pneumonia (p=0.004) and IIM relapses (p=0.013) than those without dysphagia. There was no difference between the groups as regards the occurrence of IIM-related cancers or death. <h3>Conclusion:</h3> Anti-Mi2 positivity and dysphonia are independent predictive factors of occurrence of dysphagia in patients of African ancestry with IIM. There may be a potential correlation with ethnicity but additional comparative data are required. <b>Table 1.</b> Baseline characteristics of patients with inflammatory myopathy in Martinique regarding the presence of dysphagia. * The presence or absence of dysphagia was unknown in 5 patients. <h3>REFERENCES:</h3> [1] Lilleker JB, Vencovsky J, Wang G, <i>et al.</i> The EuroMyositis registry: an international collaborative tool to facilitate myositis research. <i>Ann Rheum Dis</i> 2018; <b>77</b>: 30–9. [2] Labeit B, Pawlitzki M, Ruck T, <i>et al.</i> The Impact of Dysphagia in Myositis: A Systematic Review and Meta-Analysis. <i>J Clin Med</i> 2020; <b>9</b>: 2150. [3] Pinal-Fernandez I, Mecoli CA, Casal-Dominguez M, <i>et al.</i> More prominent muscle involvement in patients with dermatomyositis with anti-Mi2 autoantibodies. <i>Neurology</i> 2019; <b>93</b>: e1768–77. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Benoit Suzon Speaker for GSK, Rachel Robert: None declared, Aurore Abel: None declared, Fabienne Louis-Sidney: None declared, Arthur Felix: None declared, Emmanuelle Amazan: None declared, Remi Bellance: None declared, Aurélie Parsemain: None declared, Florence Moinet: None declared, Illitch Coco-Viloin: None declared, Rodolphe Cougnaud: None declared, Cécile Erere NGayap: None declared, Moustapha Dramé: None declared, Christophe Deligny: None declared.