predictors of survival in a cohort of patients with polymyositis and dermatomyositis effect of corticosteroids, methotrexate and azathioprine预测在一群生存多发性肌炎和皮肌炎患者糖皮质激素的影响,甲氨蝶呤和咪唑硫嘌呤.pdfVIP

Schiopu et al. Arthritis Research Therapy 2012, 14:R22 /content/14/1/R22 RESEARCH ARTICLE Open Access Predictors of survival in a cohort of patients with polymyositis and dermatomyositis: effect of corticosteroids, methotrexate and azathioprine 1 1 2 3 1* Elena Schiopu , Kristine Phillips , Paul M MacDonald , Leslie J Crofford and Emily C Somers Abstract Introduction: The idiopathic inflammatory myopathies are rare diseases for which data regarding the natural history, response to therapies and factors affecting mortality are needed. We performed this study to examine the effects of treatment and clinical features on survival in polymyositis and dermatomyositis patients. Methods: A total of 160 consecutive patients (77 with polymyositis and 83 with dermatomyositis) seen at the University of Michigan from 1997 to 2003 were included. Medical records were abstracted for clinical, laboratory and therapeutic data, including initial steroid regimen and immunosuppressive use. State vital records were utilized to derive mortality and cause of death data. Survival was modeled by left-truncated Kaplan-Meier estimation and Cox regression. Results: The 5- and 10-year survival estimates were 77% (95% CI = 66 to 85), and 62% (95% CI = 48 to 73), respectively, and the rates were similar for polymyositis and dermatomyositis. Survival between the sexes was similar through 5 years and significantly lower thereafter for males (10-year survival: 18% male, 73% female; P = 0.002 for 5- to 10-year interval). The sex disparity was restricted to the polymyositis group. Increased age at diagnosis and non-Caucasian race were associated with lower survival. Intravenous versus oral corticosteroid use was associated with