impact factor, citescore
logo
In press
In Press
Recent issue
Recent issue
Recent Supplement
Recent supplement
archives
Archives
articles free
Free to view
Search
Search
 

Full Papers

 

Sex differences in idiopathic inflammatory myopathies: insights from a large multicentre observational study

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22

 

  1. Rheumatology Unit, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
  2. Rheumatology Unit, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
  3. Rheumatology Unit, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
  4. Rheumatology Unit, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
  5. Rheumatology Unit, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
  6. Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.
  7. Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.
  8. Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.
  9. Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.
  10. Rheumatology and Clinical Immunology, Department of Medicine, University of Rome Campus Biomedico, School of Medicine, Rome, Italy.
  11. Rheumatology and Clinical Immunology, Department of Medicine, University of Rome Campus Biomedico, School of Medicine, Rome, Italy.
  12. Rheumatology and Clinical Immunology, Department of Medicine, University of Rome Campus Biomedico, School of Medicine, Rome, Italy.
  13. Rheumatology and Clinical Immunology, Department of Medicine, University of Rome Campus Biomedico, School of Medicine, Rome, Italy.
  14. Department Life Sciences, Health and Health Professions, Link Campus University, Rome; and Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Campus Bio-Medico, Rome, Italy.
  15. Rheumatology and Clinical Immunology, Department of Medicine, University of Rome Campus Biomedico, School of Medicine, Rome; and Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Campus Biomedico, Rome, Italy.
  16. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy. piero.ruscitti@univaq.it
  17. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
  18. Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.
  19. Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.
  20. Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.
  21. Rheumatology and Clinical Immunology, Department of Medicine, University of Rome Campus Biomedico, School of Medicine, Rome; and Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Campus Biomedico, Rome, Italy.
  22. Rheumatology Unit, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.

CER19340
Full Papers

Free to view
(click on article PDF icon to read the article)

PMID: 42154643 [PubMed]

Received: 22/09/2025
Accepted : 19/12/2025
In Press: 18/05/2026

Abstract

OBJECTIVES:
Preliminary evidence suggests sex-related variations in clinical and serological features in idiopathic inflammatory myopathies (IIMs), yet comprehensive cohort studies, particularly within the Italian population, remain scarce. The aim of this study is to assess sex differences in clinical phenotype, serological features, and disease activity, and to identify independent associated factors of disease activity in a well-characterised multi-centre Italian IIMs cohort.
METHODS:
A total of 228 IIMs patients from 5 tertiary Rheumatology Units across Italy were included. Demographic, clinical, serological, and treatment data were collected. Continuous variables are reported as mean ± SD or median (IQR), categorical variables as n (%). Comparisons between the 2 sexes were assessed by Student’s t-test, Mann-Whitney U test, χ², or Fisher’s exact test. Independent associated factors of disease activity (MYOACT) were assessed through multivariable linear regression analysis.
RESULTS:
Of 228 patients, 157 (68.9%) were female, and 71 (31.1%) were male. Age at diagnosis was similar between sexes. Males showed significantly higher disease activity measured by the MYOACT index. Multivariable analyses identified male sex, MDA5 autoantibody positivity, and greater disease damage extent as independent associated factors of higher disease activity, whereas dermatomyositis and polymyositis were associated with lower disease activity. Furthermore, MYOACT showed good predictive ability to define patients at risk for intensive care unit admission with an optimal threshold of 0.23.
CONCLUSIONS:
These findings highlight relevant sex-related differences in clinical expression and may support more personalised management strategies.

DOI: https://doi.org/10.55563/clinexprheumatol/vnkfsy

Rheumatology Article

Rheumatology Addendum