Patient–physician discordance in idiopathic inflammatory myopathies: a longitudinal analysis of links to disease activity and damage
Authors' conclusion
Patient-physician discordance in IIM is an active, upstream driver of future functional loss, mediated significantly by pain, rather than a mere reflection of existing objective damage.
Study context
- Population
- Patients with idiopathic inflammatory myopathies (IIM) (DM, PM, overlap myositis, anti-synthetase syndrome) in the MyoCite IIM cohort128 followed longitudinally
- Participants
- 244 patients
- Outcome
- Prevalence of patient–physician discordance (PGA vs PhGA difference ≥ ±1 cm on 0-10 cm scale)
- Follow-up
- Baseline
Methodological detailslongitudinal, linear mixed-effects models, bidirectional mediation models
- Longitudinal
- Linear mixed-effects models
- Bidirectional mediation models
Main finding
As reported in the abstract
Clinically significant baseline discordance
Clinically significant baseline discordance
19.3%
Positive discordance (PGA > PhGA)
16.8%
Observational data: associations, not effects.
Further findings
Discordance over 24 months
- Persistent discordance subset, with high subjective pain despite normalized muscle enzymes
- 25%
- Discordance narrowed with treatment
Baseline positive discordance predicting poorer functional capacity (HAQ) · 1 year
- Strongly predicted poorer HAQ
- P = 0.034
Objective muscle weakness (MMT-8) as driver of discordance
- MMT-8 β
- −0.013 (95% CI −0.022 to −0.004)
- Standardized β (P = 0.006)
- −0.155
- Fluctuations had minimal absolute impact
- n = 191 in linear mixed-effects models
Mediation of future functional disability by unmanaged pain
- Proportion mediated (P < 0.001)
- 32.1%
- Reverse mediation (HAQ driving discordance via pain) not statistically significant
Original publication
Patient–physician discordance in idiopathic inflammatory myopathies: a longitudinal analysis of links to disease activity and damage. Rheumatology (Oxford). Published 9 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →