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The Impact of Dysphagia in Myositis: A Systematic Review and Meta-Analysis

(1) Background: Dysphagia is a clinical hallmark and part of the current American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) diagnostic criteria for idiopathic inflammatory myopathy (IIM). However, the data on dysphagia in IIM are heterogenous and partly conflicting. The...

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Autores principales: Labeit, Bendix, Pawlitzki, Marc, Ruck, Tobias, Muhle, Paul, Claus, Inga, Suntrup-Krueger, Sonja, Warnecke, Tobias, Meuth, Sven G., Wiendl, Heinz, Dziewas, Rainer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408750/
https://www.ncbi.nlm.nih.gov/pubmed/32650400
http://dx.doi.org/10.3390/jcm9072150
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author Labeit, Bendix
Pawlitzki, Marc
Ruck, Tobias
Muhle, Paul
Claus, Inga
Suntrup-Krueger, Sonja
Warnecke, Tobias
Meuth, Sven G.
Wiendl, Heinz
Dziewas, Rainer
author_facet Labeit, Bendix
Pawlitzki, Marc
Ruck, Tobias
Muhle, Paul
Claus, Inga
Suntrup-Krueger, Sonja
Warnecke, Tobias
Meuth, Sven G.
Wiendl, Heinz
Dziewas, Rainer
author_sort Labeit, Bendix
collection PubMed
description (1) Background: Dysphagia is a clinical hallmark and part of the current American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) diagnostic criteria for idiopathic inflammatory myopathy (IIM). However, the data on dysphagia in IIM are heterogenous and partly conflicting. The aim of this study was to conduct a systematic review on epidemiology, pathophysiology, outcome and therapy and a meta-analysis on the prevalence of dysphagia in IIM. (2) Methods: Medline was systematically searched for all relevant articles. A random effect model was chosen to estimate the pooled prevalence of dysphagia in the overall cohort of patients with IIM and in different subgroups. (3) Results: 234 studies were included in the review and 116 (10,382 subjects) in the meta-analysis. Dysphagia can occur as initial or sole symptom. The overall pooled prevalence estimate in IIM was 36% and with 56% particularly high in inclusion body myositis. The prevalence estimate was significantly higher in patients with cancer-associated myositis and with NXP2 autoantibodies. Dysphagia is caused by inflammatory involvement of the swallowing muscles, which can lead to reduced pharyngeal contractility, cricopharyngeal dysfunction, reduced laryngeal elevation and hypomotility of the esophagus. Swallowing disorders not only impair the quality of life but can lead to serious complications such as aspiration pneumonia, thus increasing mortality. Beneficial treatment approaches reported include immunomodulatory therapy, the treatment of associated malignant diseases or interventional procedures targeting the cricopharyngeal muscle such as myotomy, dilatation or botulinum toxin injections. (4) Conclusion: Dysphagia should be included as a therapeutic target, especially in the outlined high-risk groups.
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spelling pubmed-74087502020-08-13 The Impact of Dysphagia in Myositis: A Systematic Review and Meta-Analysis Labeit, Bendix Pawlitzki, Marc Ruck, Tobias Muhle, Paul Claus, Inga Suntrup-Krueger, Sonja Warnecke, Tobias Meuth, Sven G. Wiendl, Heinz Dziewas, Rainer J Clin Med Review (1) Background: Dysphagia is a clinical hallmark and part of the current American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) diagnostic criteria for idiopathic inflammatory myopathy (IIM). However, the data on dysphagia in IIM are heterogenous and partly conflicting. The aim of this study was to conduct a systematic review on epidemiology, pathophysiology, outcome and therapy and a meta-analysis on the prevalence of dysphagia in IIM. (2) Methods: Medline was systematically searched for all relevant articles. A random effect model was chosen to estimate the pooled prevalence of dysphagia in the overall cohort of patients with IIM and in different subgroups. (3) Results: 234 studies were included in the review and 116 (10,382 subjects) in the meta-analysis. Dysphagia can occur as initial or sole symptom. The overall pooled prevalence estimate in IIM was 36% and with 56% particularly high in inclusion body myositis. The prevalence estimate was significantly higher in patients with cancer-associated myositis and with NXP2 autoantibodies. Dysphagia is caused by inflammatory involvement of the swallowing muscles, which can lead to reduced pharyngeal contractility, cricopharyngeal dysfunction, reduced laryngeal elevation and hypomotility of the esophagus. Swallowing disorders not only impair the quality of life but can lead to serious complications such as aspiration pneumonia, thus increasing mortality. Beneficial treatment approaches reported include immunomodulatory therapy, the treatment of associated malignant diseases or interventional procedures targeting the cricopharyngeal muscle such as myotomy, dilatation or botulinum toxin injections. (4) Conclusion: Dysphagia should be included as a therapeutic target, especially in the outlined high-risk groups. MDPI 2020-07-08 /pmc/articles/PMC7408750/ /pubmed/32650400 http://dx.doi.org/10.3390/jcm9072150 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Labeit, Bendix
Pawlitzki, Marc
Ruck, Tobias
Muhle, Paul
Claus, Inga
Suntrup-Krueger, Sonja
Warnecke, Tobias
Meuth, Sven G.
Wiendl, Heinz
Dziewas, Rainer
The Impact of Dysphagia in Myositis: A Systematic Review and Meta-Analysis
title The Impact of Dysphagia in Myositis: A Systematic Review and Meta-Analysis
title_full The Impact of Dysphagia in Myositis: A Systematic Review and Meta-Analysis
title_fullStr The Impact of Dysphagia in Myositis: A Systematic Review and Meta-Analysis
title_full_unstemmed The Impact of Dysphagia in Myositis: A Systematic Review and Meta-Analysis
title_short The Impact of Dysphagia in Myositis: A Systematic Review and Meta-Analysis
title_sort impact of dysphagia in myositis: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408750/
https://www.ncbi.nlm.nih.gov/pubmed/32650400
http://dx.doi.org/10.3390/jcm9072150
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