{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T04:56:59Z","timestamp":1792299419317,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,4,10]],"date-time":"2019-04-10T00:00:00Z","timestamp":1554854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009947","name":"Merck Sharp and Dohme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009947","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Inflammatory idiopathic myositis (IIM) comprises a heterogeneous group of systemic muscular diseases that can occur together with other connective tissue diseases (CTD), named overlap myositis (OM). The question of whether OM is a distinct entity still remains controversial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The present study was conducted to assess the clinical and prognostic differences between patients diagnosed with OM, primary polymyositis (PM) and primary dermatomyositis (DM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The study consists of a retrospective longitudinal and multicenter series of IIM patients. Patients were classified as OM, PM and DM. Overlap myositis was defined as patients fulfilling criteria for IIM plus criteria for other CTD (namely systemic sclerosis, systemic lupus erythematosus, mixed connective tissue disease, rheumatoid arthritis and primary Sj\u00f6gren's syndrome).<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>A total of 342 patients were included (98 OM, 137 PM and 107 DM). Overlap myositis patients, in comparison with PM and DM, showed significant differences, with more extramuscular involvement, particularly more arthritis (66%, 34.6% and 48.1%, respectively), puffy fingers (49.5%, 11.1% and 24.3%), sclerodactyly (45.4%, 2.2% and 2%), dysphagia (41.8%, 18.2% and 26.4%), Raynaud phenomenon (65.3%, 16.9% and 19.8%), leucopenia (28.9%, 2.2% and 8.4%), thrombocytopenia (8.2%, 2.2% and 1.9%), interstitial lung disease (ILD) (48%, 35% and 30.8%), renal manifestations (13.4%, 3.7% and 1.9%), and more severe infections (41.3%, 26.7% and 21%). No significant differences were found in survival between groups in log rank test (<jats:italic>P\u00a0<\/jats:italic>=\u00a00.106). Multivariate adjusted survival analyses revealed a worse prognosis for severe infections, ILD and baseline elevation of acute phase reactants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Overlap myositis stands out as a distinct entity as compared to PM and DM, featuring more extramuscular involvement and more severe infections. Close monitoring is recommended in this subset for early detection and treatment of possible complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.13559","type":"journal-article","created":{"date-parts":[[2019,4,10]],"date-time":"2019-04-10T07:07:06Z","timestamp":1554880026000},"page":"1393-1401","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Overlap myositis, a distinct entity beyond primary inflammatory myositis: A retrospective analysis of a large cohort from the REMICAM registry"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7152-0458","authenticated-orcid":false,"given":"Laura","family":"Nu\u00f1o\u2010Nu\u00f1o","sequence":"first","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario La Paz Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz Esther","family":"Joven","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario Doce de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia E.","family":"Carreira","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario Doce de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Maldonado\u2010Romero","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario Ram\u00f3n y Cajal Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Larena\u2010Grijalba","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario Ram\u00f3n y Cajal Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Llorente Cubas","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario La Princesa Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Tomero","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario La Princesa Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Carmen","family":"Barbadillo\u2010Mateos","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario Puerta de Hierro Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma","family":"Garc\u00eda de la Pe\u00f1a Lefebvre","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario Madrid Norte Sanchinarro Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda","family":"Ruiz\u2010Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario Infantil Ni\u00f1o Jes\u00fas Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"L\u00f3pez\u2010Robledillo","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario Infantil Ni\u00f1o Jes\u00fas Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Moruno\u2010Cruz","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario Pr\u00edncipe de Asturias Alcal\u00e1 de Henares Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario Pr\u00edncipe de Asturias Alcal\u00e1 de Henares Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana","family":"Cobo\u2010Ib\u00e1\u00f1ez","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda, Hospital Universitario Infanta Sof\u00eda Universidad Europea de Madrid Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Almod\u00f3var","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n Alcorc\u00f3n, Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leticia","family":"Lojo","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital Universitario Infanta Leonor Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jes\u00fas","family":"Garc\u00eda de Y\u00e9benes","sequence":"additional","affiliation":[{"name":"Instituto de Salud Musculoesquel\u00e9tica Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Javier","family":"L\u00f3pez\u2010Longo","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda Hospital General Universitario Gregorio Mara\u00f1\u00f3n Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu289"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000173991.74008.b0"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001144"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2012.06.004"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780140210"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.08.023"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/08916930600622603"},{"key":"e_1_2_7_9_1","first-page":"S109","article-title":"Mortality in idiopathic inflammatory myopathies","volume":"26","author":"Lundberg IE","year":"2008","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-005-1164-z"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197502132920706"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.151425"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009742.2013.868512"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204487"},{"key":"e_1_2_7_15_1","first-page":"668","article-title":"Classification criteria for polymyositis and dermatomyositis","volume":"22","author":"Tanimoto K","year":"1995","journal-title":"J Rheumatol"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780230510"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400928"},{"key":"e_1_2_7_19_1","first-page":"328","article-title":"Comparison between 3 diagnostic criteria for mixed connective tissue disease. Study of 593 patients","volume":"16","author":"Alarcon\u2010Segovia D","year":"1989","journal-title":"J Rheumatol"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780290501"},{"key":"e_1_2_7_21_1","first-page":"438","article-title":"Dermatomyositis and polymyositis associated with malignancy: a 21\u2010year retrospective study","volume":"35","author":"Andras C","year":"2008","journal-title":"J Rheumatol"},{"issue":"6","key":"e_1_2_7_22_1","first-page":"331","article-title":"Multicenter registry on inflammatory myositis from the Rheumatology Society in Madrid, Spain: descriptive analysis","volume":"13","author":"Nu\u00f1o L","year":"2016","journal-title":"Reumatol Clin"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-017-3799-x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/0049-0172(86)90014-4"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2009.08.008"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211868"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/36.10.1067"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-014-2730-z"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2011.07.010"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar4562"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780280303"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000109755.65914.5e"},{"key":"e_1_2_7_33_1","first-page":"263","article-title":"Long\u2010term prognosis of 69 patients with dermatomyositis or polymyositis","volume":"14","author":"Maugars YM","year":"1996","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-015-3139-z"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.3109\/14397595.2015.1054081"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30513"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-009-1110-6"},{"key":"e_1_2_7_38_1","first-page":"820","article-title":"Why do patients with myositis die? A retrospective analysis of a single\u2010centre cohort","volume":"34","author":"Amaral SM","year":"2016","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203312456751"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-014-3198-5"}],"container-title":["International Journal of Rheumatic Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185X.13559","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1756-185X.13559","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185X.13559","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T06:50:55Z","timestamp":1694328655000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1756-185X.13559"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,10]]},"references-count":39,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1111\/1756-185X.13559"],"URL":"https:\/\/doi.org\/10.1111\/1756-185x.13559","archive":["Portico"],"relation":{},"ISSN":["1756-1841","1756-185X"],"issn-type":[{"value":"1756-1841","type":"print"},{"value":"1756-185X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4,10]]},"assertion":[{"value":"2018-07-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}