Current Rheumatology Reports

, Volume 7, Issue 2, pp 87–93 | Cite as

Outcomes and disease activity measures for assessing treatments in the idiopathic inflammatory myopathies

  • Chester V. Oddis
Article

Abstract

The assessment and treatment of patients with idiopathic inflammatory myopathy has taken a major step forward over the past few years. Through the efforts of multi-disciplinary international groups of experts interested in the management of patients with myositis, initiatives have led to the development of a core set of outcome measures critical to their assessment. Similarly, the lack of consensus on several issues of clinical trial design has been addressed resulting in the development of a definition of clinical improvement for adult and juvenile patients with inflammatory myopathy using the core set outcomes. The final step in the puzzle of well-designed therapeutic trials in myositis is the determination of consensus guidelines to conduct such trials in adult and pediatric populations of myositis patients.

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References and Recommended Reading

  1. 1.
    OddisCV, Conte CG, Steen VD, Medsger TA Jr: Incidence of polymyositis-dermatomyositis: a 20-year study of hospital diagnosed cases in Allegheny County, PA 1963–1982. JRheumatol 1990, 17:1329–1334.Google Scholar
  2. 2.
    Love LA, Leff RL, Fraser DD, et al.: A new approach to the classification of idiopathic inflammatory myopathy: myositis-specific autoantibodies define useful homogeneous patient groups. Medicine 1991, 70:360–374.PubMedCrossRefGoogle Scholar
  3. 3.
    PachmanL M, Hayford JR, Chung A, et al.: Juvenile dermato-myositis at diagnosis: clinical characteristics of 79 children. JRheumatol 1998, 25:1198–1204.Google Scholar
  4. 4.
    Huber AM, Lang B, LeBlanc CM, et al.: Medium-and long-term functional outcomes in a multicenter cohort of children with juvenile dermatomyositis. Arthritis Rheum 2000, 43:541–549.PubMedCrossRefGoogle Scholar
  5. 5.
    Stoll T, Stucki G, Malik J, et al.: Association of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index with measures of disease activity and health status in patients with systemic lupus erythematosus. J Rheumatol 1997, 24:309–313.PubMedGoogle Scholar
  6. 6.
    Miller FW, Rider LG, Chung YL, etal.: Proposed preliminary core set measures for disease outcome assessment in adult and juvenile idiopathic inflammatory myopathies. Rheumatology 2001, 40:1262–1273.PubMedCrossRefGoogle Scholar
  7. 7.
    Rider LG, Giannini EH, Harris-Love M, et al.: Defining clinical improvement in adult and juvenile myositis. J Rheumatol 2003, 30:603–617.This excellent review summarizes the proceedings of a workshop and reviews the core set measures outlined in Table 1 and defines the degree of change in each measure that is clinically significant.PubMedGoogle Scholar
  8. 8.
    SultanSM: Clinical assessment in adult onset idiopathic inflammatory myopathy. Curr Opin Rheumatol 2004, 16:668–672.PubMedCrossRefGoogle Scholar
  9. 9.
    Isenberg DA, Allen E, Farewell V, Ehrenstein MR, et al.: International consensus outcome measures for patients with idiopathic inflammatory myopathies. Development and initial validation of myositis activity and damage indices in patients with adult onset disease. Rheumatology 2004, 43:49–54.This article describes new tools to assess activity and damage in patients with IIM.PubMedCrossRefGoogle Scholar
  10. 10.
    Rider LG, Feldman BM, Perez MD, et al.: Development of validated disease activity and damage indices for the juvenile idiopathic inflammatory myopathies: I. physician, parent, and patient global assessments. Juvenile Dermatomyositis Disease Activity Collaborative Study Group. Arthritis Rheum 1997, 40:1976–1983.PubMedCrossRefGoogle Scholar
  11. 11.
    Hicks JE, Wesley R, Koziol D, et al.: Validation of manual muscle testing (MMT) in the assessment of juvenile dermatomyositis (JDM) [abstract]. Arthritis Rheum 2000, 43(Suppl):S194.Google Scholar
  12. 12.
    Feldman BM, Ayling-Campos A, Luy L, et al.: Measuring disability in juvenile dermatomyositis: validity of the childhood health assessment questionnaire. J Rheumatol 1995,22:326–331.PubMedGoogle Scholar
  13. 13.
    Huber AM, et al.: Construct validity and responsiveness of the child health assessment questionnaire (CHAQ) in juvenile idiopathic inflammatory myopathy (JIIM) [abstract]. Arthritis Rheum 1999, 42(Suppl 9):S182.Google Scholar
  14. 14.
    Lovell DJ, Lindsley CB, Rennebohm RM, et al.: Development of validated disease activity and damage indices for the juvenile idiopathic inflammatory myopathies. II. The Childhood Myositis Assessment Scale (CMAS): a quantitative tool for the evaluation of muscle function. The Juvenile Dermatomyositis Disease Activity Collaborative Study Group. Arthritis Rheum 1999, 42:2213–2219.PubMedCrossRefGoogle Scholar
  15. 15.
    Josefson PA, Romanus E, Carlsson J: A functional index in myositis. J Rheumatol 1996, 23:1380–1384.PubMedGoogle Scholar
  16. 16.
    Csuka M, McCarty DJ: Simple method for measurement of lower extremity muscle strength. Am J Med 1985, 78:77–81.PubMedCrossRefGoogle Scholar
  17. 17.
    Ruperto N, Ravelli A, Murray KJ, et al.: Preliminary core sets of measure for disease activity and damage assessment in juvenile systemic lupus erythematosus and juvenile dermatomyositis. Rheumatology 2003, 42:1452–1459.PubMedCrossRefGoogle Scholar
  18. 18.
    Rider LG, et al.: Defining clinically relevant change in core set activity measures for adult and juvenile idiopathic inflammatory myopathies (IIM). Arthritis Rheum 2002, 46:S613.Google Scholar
  19. 19.
    Rider LG, Giannini EH, Brunner HI, et al.: International Consensus on Preliminary Definitions of Improvement in adult and juvenile myositis. Arthritis Rheum 2004, 50:2281–2290.This important article summarizes the process whereby the core set outcome measures were utilized to develop an international preliminary definition of improvement for adult and juvenile myositis as an endpoint for therapeutic trials.PubMedCrossRefGoogle Scholar
  20. 20.
    Oddis CV, Miller F, Konerv B, et al.: Development of consensus criteria on the conduct of clinical trials in adult and juvenile idiopathic inflammatory myopathy (IIM). Arthritis Rheum 2003, 48:S308-S309.Google Scholar
  21. 21.
    Bohan A, Peter JB: Polymyositis and dermatomyositis (first of two parts). N Engl J Med 1975, 292:344–347.PubMedCrossRefGoogle Scholar
  22. 22.
    Bohan A, Peter JB: Polymyositis and dermatomyositis (second of two parts). N Engl J Med 1975, 292:403–407.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc 2005

Authors and Affiliations

  • Chester V. Oddis
    • 1
  1. 1.Division of Rheumatology and Clinical ImmunologyUniversity of Pittsburgh School of MedicinePittsburghUSA

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