Poster Session A
Myopathic rheumatic diseases (polymyositis, dermatomyositis, inclusion body myositis)
Rohit Aggarwal, MD,MS (he/him/his)
Professor
University of Pittsburgh
Pittsburgh, PA, United States
No financial relationships with ineligible companies to disclose
A total of 174 patients with DM were included. Of these, 66% were female and 89% were White, with a median age of 54 years (45‒63). Over a follow-up of 4.0 years (1.3‒7.3), 94% received GC. The median (range) starting dose was 25.8 mg (15.0‒40.0). In the third year, GC was being used in 76% of patients at a dose of 5.0 mg (4.0‒10.0). A high proportion (68%) of patients were still on GC in the fifth year following the index date, at a dose of 5.0 mg (4.0–7.5). In addition to GC, 54% of patients received methotrexate, 37% mycophenolate, 32% hydroxychloroquine, 27% azathioprine, and 21% intravenous immunoglobulin. Median scores at the index date were 3.5 (1.9‒5.0) for PGA, 146 (137‒150) for MMT-8, and 2.7 (1.5‒4.0) for EMGA. PGA, MMT-8, and EMGA improved overtime while on treatment with methotrexate (n=94 patients), hydroxychloroquine (n=56), or mycophenolate (n=65), as depicted in Figures 1, 2 and 3, respectively. Median time between IIM diagnosis and treatment initiation was 34 days (1‒140) for methotrexate, 55 days (1‒326) for hydroxychloroquine, and 395 days (23‒1105) for mycophenolate. In the second year of treatment, 50 patients were still followed in the methotrexate group, 25 in the hydroxychloroquine group, and 21 in the mycophenolate group. Even after two years of treatment, PGA and EMGA remained greater than 0 in some patients, suggesting active disease.
Conclusion:
Despite use of immunosupressants, a significant proportion of DM patients remained on GC for several years, many at doses known to be associated with long-term side effects ( >5 mg/day). These findings highlight the unmet medical need for alternative and GC-sparing therapies for patients with DM.
Medical editing support was provided by Bioscript Group.
Figure 1. Evolution of PGA, MMT-8, and EMGA while on treatment with methotrexate
Figure 2. Evolution of PGA, MMT-8, and EMGA while on treatment with hydroxychloroquine
Figure 3. Evolution of PGA, MMT-8, and EMGA while on treatment with mycophenolate
C. Oddis: Abcuro, 5, Alexion, 5, Argenx, 5, Boehringer Ingelheim, 5, CSL Behring, 5, EMD Serono, 5, Janssen, 5, Pfizer, 5, Priovant, 5; J. Feifel: the healthcare business of Merck KGaA, Darmstadt, Germany, 3; D. Ascherman: None; D. Koontz: None; C. Foch: the healthcare business of Merck KGaA, Darmstadt, Germany, 3; L. Henkel: Merck Healthcare Germany GmbH, Weiterstadt, Germany, an affiliate of Merck KGaA, Darmstadt, Germany, 3; J. Muir: Cytel, Inc, 3, EMD Serono, 2; D. Denis: EMD Serono, 3; R. Aggarwal: Alexion, 2, ANI Pharmaceuticals, 2, Argenx, 2, AstraZeneca, 2, Boehringer-Ingelheim, 2, 5, Bristol-Myers Squibb(BMS), 2, 5, CabalettaBio, 2, Capella Bioscience, 2, Capstanx, 2, Corbus, 2, CSL Behring, 2, EMD Serono, 2, 5, Galapagos, 2, Horizon Therapeutics, 2, I-Cell, 2, Immunovant, 2, Janssen, 1, 2, 5, Kezar, 2, Kyverna, 2, Lilly, 2, Mallinckrodt, 5, Manta Medicines Corporation, 2, Merck, 2, Novartis, 2, Nuvig Therapeutics, 2, Octapharma, 2, Pfizer, 2, 5, Q32, 5, Roivant, 2, Sanofi, 2, Teva, 2.