Abstract Background/Aims Inflammatory myopathies are a rare, heterogeneous group of autoimmune muscle diseases with variable clinical presentations. Advances in myositis-specific and myositis-associated autoantibody profiling have enhanced diagnostic accuracy and prognostic classification. However, data from non-tertiary care settings remain limited. Methods A retrospective review was conducted of 23 patients diagnosed with inflammatory myopathies at Basingstoke District Hospital between 2020 and 2023. Demographic data, clinical features, autoantibody profiles, imaging findings, treatment modalities, and outcomes were extracted from electronic health records. Results The cohort ranged in age from 36-84 years (median: 67) with a female/male ratio of 2.83. Common presenting features included proximal muscle weakness, cutaneous manifestations, and fatigue. Only 13% of patients demonstrated creatine kinase (CK) elevations ≥10 times the upper limit of normal. Autoantibody distribution differed from established epidemiological trends: anti-Jo-1 was rare, while anti-HMG-CoA reductase (linked to immune-mediated necrotising myopathy) and anti-cN1a (associated with inclusion body myositis) were more prevalent. Several patients demonstrated multiple antibody positivity, though its clinical significance remains unclear. No patients tested positive for TIF1-γ or NXP2, antibodies typically associated with malignancy-related and severe juvenile dermatomyositis. Almost all patients underwent imaging, though only one had a muscle biopsy. Treatments primarily consisted of corticosteroids and disease-modifying antirheumatic drugs (DMARDs). Clinical improvement in muscle strength was observed in 87% of patients, although 50% continued to experience functional limitations. Notably, 71.4% of referrals occurred following COVID-19 vaccination. Conclusion This single-centre cohort underscores the heterogeneity of inflammatory myopathies in a non-tertiary care setting, with distinct serological patterns and therapeutic responses compared with larger datasets. The findings highlight the importance of antibody-guided diagnosis, early initiation of therapy, and structured follow-up. Further multicentre studies are needed to explore the implications of dual antibody positivity and to investigate potential temporal associations with COVID-19 vaccination. Disclosure T. Yap: None. E. Gurung: None. N. Ahmad: None. M. Malik: None. L. Yalakki: None.
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