LAUSR

Background In Idiopathic Inflammatory Myopathies (MII), 18%–20% of patients have dysphagia. Objectives To evaluate the frequency of dysphagia in patients with MII, association with other manifestations of the disease, treatment and evolution. To evaluate clinical characteristics and evolution of severe dysphagia. To compare clinical characteristics and evolution of mild-moderate versus severe dysphagia. Methods Retrospective, observational study. Patients with a diagnosis of MII were included according to modified classification criteria of Bohan and Peter. Demographic, clinical and complementary studies were recorded. Serious dysphagia was considered: contraindication of oral feeding. Descriptive statistics were performed. Chi2 test, Student’s test or Mann Whitney as appropriate. Results We included 91 of 106 patients evaluated from 1992 to 2017: 76% female, mean age at diagnosis 48±14 years. 53% presented dysphagia: mild/moderate 62.5% (30/48 pts), severe 37.5% (18/48). Idiopathic dermatomyositis was the most frequent MII in these patients (71%). In patients with dysphagia, proximal muscle weakness was 90%, weakness of neck muscles 45%, weakness of respiratory muscles 27%. A significant association was found between dysphagia and weakness of respiratory muscles, weak neck muscles, glucocorticoid pulses, gammaglobulin, grave infections and death. (Data not shown in the summary). In patients with severe dysphagia, we observed a significant association with the requirement for mechanical ventilation, hospitalisation in an intensive care unit, serious infections and death (table 1). When comparing mild-moderate dysphagia vs severe dysphagia, a statistically significant association was found with neck muscles weakness, respiratory muscle weakness, glucocorticoid pulses, gamma globulin use, requirement for mechanical ventilation, hospitalisation in an intensive care unit, severe infections and mortality (table 2).Abstract AB0725 – Table 1 Severe dysphagia (SI) 18/91 Severe dysphagia (NO) 72/91 p OR IC 95% Weakness of respiratory muscles 8/18 6/63 0 00 054 7,6 2,1–26,6 Weak neck muscles 8/16 6/63 0 00 129 8 2,5–26 Glucocorticoid pulses 12/18 8/69 <0,0001 15 4,4–51,9 Gammaglobulin 10/18 7/72 <0,0008 11,60 0,8–10 Intensive therapy unit 7/18 8/72 0,0046 5 1,5–16,8 Mechanical respiratory assistance 6/18 5/72 0002 6,70 1,7–25 Grave Infections 10/17 11/66 0,0003 7 2,2–22,8 Death 12/18 9/72 <0,0001 14 4,2–46,6Abstract AB0725 – Table 2 Dysphagia(mild-moderate) 30/48 Dysphagia(severe)18/48 p OR IC 95% Weakness of respiratory muscles 4/30 9/18 0005 6,5 1,6–26 Weak neck muscles 9/30 13/18 0004 6 1,6–22 Glucocorticoid pulses 5/28 13/18 0,0002 12 2,9–49 Gammaglobulin 3/30 10/18 0,0005 10 2,4–51 Intensive therapy unit 1/30 7/18 0,0013 18 2–167 Mechanical respiratory assistance 1/30 6/18 0004 14,50 1,5–133 Grave Infections 5/27 10/18 0009 5,50 1,4–21 Death 3/30 13/18 <0.001 23,5 4,8–113 Conclusions Fifty-three percent of patients with MII had dysphagia at some point during their evolution. Severe dysphagia was associated with parameters of disease severity, poor prognosis and increased mortality. Disclosure of Interest None declared