medwireNews: Nearly all patients with myositis report current or past pain, which is often treated with opioids, shows a survey by the patient-led advocacy organization Myositis Support and Understanding.
Salman Bhai (University of Texas Southwestern Medical Center, Dallas, USA) and co-investigators say their findings “underline the importance of treating physicians to inquire and treat the pain these patients experience.”
Of the 423 people (74.6% women) who completed the survey, 43.3% had dermatomyositis, 31.0% had inclusion body myositis, and 25.7% had polymyositis.
The majority (91.5%) of participants reported current or past pain and 99.0% of these said that their pain was due to myositis.
The researchers report in Rheumatology that there was no significant association between pain and myositis duration, but there was a significant difference in pain rates among the myositis types; the highest rate occurred among people with dermatomyositis (97.2%), followed by polymyositis (94.5%) and inclusion body myositis (80.9%).
Indeed, multivariable analysis showed that individuals with dermatomyositis were a significant 3.7 times more likely to experience pain that those with inclusion body myositis.
Conversely, people aged 60 years and older were a significant 80% less likely to experience pain than younger respondents, Bhai et al note.
Of the 387 participants who reported pain, 69.0% were using opioids and 92.8% were using non-opioid medications including nonsteroidal anti-inflammatory drugs (59%), acetaminophen (45%), neuropathic medications (20%), herbal medications (8%), and steroids (3%).
Opioid use was a significant twice as likely among people with polymyositis relative to those with inclusion body myositis but was no more likely among those with dermatomyositis nor was there any difference by age or sex.
In addition, there were no significant associations between non-opioid pain medication use and either myositis subtype, sex, or age.
“To our knowledge, this is the first and largest data set to show the prevalence of pain in myositis as well as predictors of pain and medication use in patients with myositis,” Bhai and co-authors remark.
They say that the “study highlights the importance of addressing pain as part of myositis treatment” and suggest that use of a wide range of pain medications ”merits future research into determining analgesic protocols or treatment plans for these patients.”
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Rheumatology 2022; doi:10.1093/rheumatology/keac271