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. 2025 Apr 1;64(4):2133-2142.
doi: 10.1093/rheumatology/keae520.

The impact of multimorbidity on Quality of Life in inflammatory myopathies: A cluster analysis from the COVAD dataset

Marco Fornaro  1 , Vincenzo Venerito  1 , Maria Rosa Pellico  2 , Florenzo Iannone  1 , Mrudula Joshi  3 , Yi-Ming Chen  4   5 , Ai Lyn Tan  6   7 , Sreoshy Saha  8 , Tulika Chatterjee  9 , Vishwesh Agarwal  10 , Samuel Katsuyuki Shinjo  11 , Leonardo Santos Hoff  12 , Esha Kadam  13 , Nelly Ziade  14   15 , Tsvetelina Velikova  16 , A T M Tanveer Hasan  17 , Russka Shumnalieva  18 , Marcin Milchert  19 , Chou Luan Tan  20 , Abraham Edgar Gracia-Ramos  21 , Lorenzo Cavagna  22 , Binit Vaidya  23 , Masataka Kuwana  24 , Syahrul Sazliyana Shaharir  25 , Johannes Knitza  26 , Ashima Makol  27 , Erick Adrian Zamora Tehozol  28 , Jorge Rojas Serrano  29 , Hussein Halabi  30 , Dzifa Dey  31 , Carlos Enrique Toro-Gutiérrez  32 , Phonpen Akarawatcharangura Goo  33 , Carlo V Caballero-Uribe  34 , Oliver Distler  35 , Wanruchada Katchamart  36 , Jessica Day  37   38   39 , Ioannis Parodis  40   41 , Elena Nikiphorou  42   43 , Hector Chinoy  44   45 , Vikas Agarwal  46 , Latika Gupta  44   47 ; CoVAD Study Group
Collaborators, Affiliations

The impact of multimorbidity on Quality of Life in inflammatory myopathies: A cluster analysis from the COVAD dataset

Marco Fornaro et al. Rheumatology (Oxford). .

Abstract

Objective: The presence of comorbidities can substantially affect patients' quality of life, but data regarding their impact on idiopathic inflammatory myopathies (IIMs) are limited.

Methods: We examined the prevalence of comorbidities in IIM patients, other autoimmune rheumatic diseases (oAIRDs) and healthy controls (HCs), using data from the self-reported COVAD-2 survey. We defined basic multimorbidity (BM) as the presence of ≥2 non-rheumatic chronic conditions and complex multimorbidity (CM) as the presence of ≥3 non-rheumatic chronic conditions affecting ≥3 organ systems. Hierarchical clustering on principal components was performed for grouping.

Results: Among the COVAD respondents, 1558 IIMs, 4591 oAIRDs and 3652 HCs were analysed. IIMs exhibited a high burden of comorbidities (odds ratio [OR]: 1.62 vs oAIRDs and 2.95 vs HCs, P < 0.01), BM (OR: 1.66 vs oAIRDs and 3.52 vs HCs, P < 0.01), CM (OR: 1.69 vs AIRDs and 6.23 vs HCs, P < 0.01) and mental health disorders (MHDs) (OR: 1.33 vs oAIRDs and 2.63 vs HCs, P < 0.01). Among the IIM patients, those with comorbidities or MHDs had lower PROMIS Global Physical (PGP), PROMIS Global Mental (PGM), and PROMIS Physical Function (SF10) scores, and higher fatigue (F4a) scores (all P < 0.001). PGP, PGM, SF10a and F4a were influenced by age, active disease, BM and MHDs. Four distinct clusters were identified among the IIMs according to comorbidities and PROMIS scores.

Conclusion: Patients with IIMs have a higher burden of comorbidities that influence physical and mental health, identifiable as clinical clusters for optimized and holistic management approaches.

Keywords: autoinflammatory condition; comorbidity; myositis; observational studies; quality of life.

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