Risk Comparative Analysis of Patients with Dermatomyositis, Obesity, or Both for the Outcome of Trigeminal Neuralgia: A Retrospective Cohort Study

Introduction: Mixed Connective Tissue Disease is a phenomenon where two or more autoimmune diseases occur simultaneously. Mixed Connective Tissue Disease can include dermatomyositis as a component of the disease, which is characterized by the presence of muscle inflammation and skin rashes. One of the common symptoms of this combinatory disease is trigeminal neuralgia. With underlying studies indicating that obesity is associated with increased sensitivity to pain, this study explores the association between dermatomyositis and its symptomatic manifestation as trigeminal neuralgia in relation to presence or absence of obesity as a diagnosis.

Methods: A retrospective data collection was carried out through TriNetX, a database that houses clinical information of patients from 92 healthcare organizations. Data for three comparative cohorts were drawn: Cohort 1 with patients with dermatomyositis and obesity (+DM+OB), cohort 2 with patients with dermatomyositis without obesity(+DM-OB), and cohort 3 with patients with obesity without dermatomyositis (-DM+OB). The time window for the outcome of interest was 1 day post-event to no limit. Propensity score was matched for age, gender, hypertension, smoking, alcohol use, multiple sclerosis, and abnormal PNS studies to eliminate confounders, and the statistical risk analyses were performed.

Results: For comparison 1, the results revealed no greater association of cohort 1 (+DM+OB) to trigeminal neuralgia compared to cohort 2 (+DM-OB) (OR [95%CI] 1.312 [0.864-1.993]). Meanwhile, comparison 2 showed that cohort 1 (DM+OB) had a greater association to trigeminal neuralgia compared to cohort 3 (-DM+OB) (1.689 [1.103-2.585]). Lastly, comparison 3 indicated that cohort 2 (DM-OB) also showed greater association to trigeminal neuralgia compared to cohort 3 (-DM+OB) (1.391 [1.061-1.825]).

Conclusion : This TriNetX-based study explicably indicates that dermatomyositis is associated with trigeminal neuralgia more than obesity when considering dermatomyositis and obesity as independent factors. Comparing cohorts 1 and 3 (obesity patients with or without dermatomyositis), cohort 1 (with dermatomyositis) showed a greater association to trigeminal neuralgia demonstrating that dermatomyositis is associated with trigeminal neuralgia in patients with obesity as a baseline. These results could be furthered by reviewing specific patient cases.