AB0806 The impact of dysphagia in idiopathic inflammatory myositis: an online survey of highly-specialised centres

Background Dysphagiarepresents a frequent and disabling symptom in patients with idiopathic inflammatory myopathies(IIM). Despite this, there are not widely accepted diagnostic and therapeutic guidelines for dysphagiain IIM. Objectives This study is aimed at surveying the approach to dysphagiain IIM patients in European and worldwide referral centres. Methods An anonym on-line survey was designed and clinicians from European Union (EU) countries, and countries from North and Central America and South Korea were invited via email to participate. The questionnaire included 11 items about the characteristics of the hospital of the responder, the evaluation of the impact of dysphagiaon disease severity assessed on a visual analogue scale (10 VAS), the techniques used for the assessment of dysphagia, the use of validated patients reported outcome (PRO) and the therapeutic approach of dysphagia. Results Between December 2017 and January 2018, 52 clinicians from different centresworking in 21 different countries (18 EU countries, 3 non-EU countries) completed the survey. The total numbers of patients followed in the participating centreswere 3817 with an average number of patients followed in each centreof 75 (±83). The majority of centresfollowed only adult patients,45 2 only paediatric patients ( In all the centresan instrumental evaluation of esophageal motility is performed: esophageal manometry in 24 centres, videofluoroscopic swallowing exam in 17, esophageal barium x-rays in 16, and pHmetry and functional endoscopy in 14 each. Esophageal scintigraphy and esophagogastroscopy were respectively performed in 5 and 3 centres. The presence of dysphagiagreatly influences the therapeutic approach to IIM in 49 centresleading to an increase of the corticosteroids dosage (11 centres), a change of the immunosuppressive treatment12 or the initiation of intravenous immunoglobulins (IvIg).26 Conclusions This study suggests that the approach to dysphagiais variable, but dysphagiahas an impact on IIM patients and influences the therapeutic decisions of the treating physician. Different therapeutic strategies are adopted regarding the treatment, and in many cases highly expensive drugs as IvIg are prescribed. Further studies and recommendations are certainly needed for homogenising the patient management for this severe aspect of the disease. Disclosure of Interest None declared