Outcome in patients with idiopathic inflammatory myositis: morbidity and mortality

Rheumatology (Oxford). 2002 Jan;41(1):22-6. doi: 10.1093/rheumatology/41.1.22.


Objective: To assess the long-term outcome of a cohort of 46 patients with idiopathic myositis by assessing both health status, as measured by the SF-36, and cumulative survival probability over a 20-yr follow-up period at a single rheumatology centre. Methods and results. Forty-six patients under long-term follow-up from 1978 to 1999 were identified from our database. All patients fulfilled three out of four of the Bohan and Peter criteria for myositis. We excluded those with malignancy-associated disease and those with inclusion body myositis. Twenty-three patients (50%) had adult-onset polymyositis, 14 (30.4%) had adult-onset dermatomyositis, one had childhood-onset dermatomyositis and eight (17.4%) had an overlap syndrome (associated with either systemic lupus erythematosus or rheumatoid arthritis). During the course of the disease, seven patients (15.2%) went into full remission, eight (17.4%) had monophasic illness, nine (19.6%) had a relapsing-remitting course, 16 (34.8%) had chronic progressive illness and six (13.04%) died. All patients had significantly lower SF-36 scores in all aspects of health compared with the general population (P< or =0.001). Patients with chronic progressive illness had significantly greater bodily pain (P< or =0.05, t-test) than those with a relapsing-remitting illness, but did not differ in other aspects of health. There was no significant difference in the scores in the different domains of the SF-36 between the patients with active disease and those with inactive disease (0.05<P<0.1). Six of the 46 patients died. Cumulative survival probability was calculated. The five-year survival rate was 95% and the 10-yr survival rate 83.8%.

Conclusion: Patients with myositis report significantly poorer health compared with the general population. Health status and disease activity are important outcome measures in the assessment of patients with myositis.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Cohort Studies
  • Dermatomyositis / diagnosis*
  • Dermatomyositis / mortality*
  • Dermatomyositis / therapy
  • Disease Progression
  • Female
  • Health Status*
  • Humans
  • Long-Term Care
  • Male
  • Middle Aged
  • Morbidity / trends*
  • Polymyositis / diagnosis*
  • Polymyositis / mortality*
  • Polymyositis / therapy
  • Probability
  • Prognosis
  • Quality of Life
  • Reference Values
  • Registries
  • Severity of Illness Index
  • Sex Distribution
  • Sickness Impact Profile
  • Survival Analysis
  • United Kingdom / epidemiology