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Treatment of inflammatory myopathies
Author(s) -
Mastaglia Frank L.,
Phillips Beverley A.,
Zilko Paul
Publication year - 1997
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/(sici)1097-4598(199706)20:6<651::aid-mus1>3.0.co;2-7
Subject(s) - polymyositis , medicine , dermatomyositis , inclusion body myositis , azathioprine , myositis , cyclophosphamide , methotrexate , chlorambucil , inflammatory myopathy , prednisone , immunotherapy , immunology , dermatology , chemotherapy , immune system , disease
The treatment of the immune‐mediated inflammatory myopathies remains largely empirical. Corticosteroids are usually effective in polymyositis and dermatomyositis but may need to be combined with methotrexate or azathioprine in some patients. Intravenous immunoglobulin (IVIg) is effective as add‐on therapy in some patients not adequately controlled with steroids or immunosuppressive agents, but further controlled trials of IVIg are necessary to define the indications and optimal dose regimens. Cyclophosphamide, cyclosporin, or chlorambucil may be effective in patients with refractory polymyositis or dermatomyositis. Low‐dose whole body or lymphoid irradiation is a last option in severely disabled patients resistant to all other treatments. As a small proportion of patients with inclusion body myositis respond to corticosteroid or immunosuppressive therapy, a 3–6‐month trial of such therapy is justified in this condition. More specific immunotherapy for these disorders awaits identification of the target antigens and further clarification of the immunopathogenetic mechanisms. © 1997 John Wiley & Sons, Inc. Muscle Nerve 20:651–664, 1997.