Drug therapy of the idiopathic inflammatory myopathies: predictors of response to prednisone, azathioprine, and methotrexate and a comparison of their efficacy

Joffe, Marshall M.; Love, Lori A.; Leff, Richard L.; Fraser, David; Targoff, Ira N.; Hicks, Jeanne E.; Plötz, Paul H.; Miller, Frederick W.

doi:10.1016/0002-9343(93)90148-i

Cited by 274 publications

(160 citation statements)

References 28 publications

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“…Myositis-specific autoantibodies (MSA) have proved clinically useful in helping to predict signs and symptoms of the disease [2][3][4]. The most common MSA, seen in about a third of the patients, are directed to aminoacyl-tRNA synthetases, enzymes which catalyse the attachment of a particular amino acid to its cognate tRNA [5].…”

Section: Introductionmentioning

confidence: 99%

Anti-Ro52 antibodies frequently co-occur with anti-Jo-1 antibodies in sera from patients with idiopathic inflammatory myopathy

Rutjes¹,

Egberts²,

Jongen³

et al. 1997

Clinical and Experimental Immunology

174

106

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SUMMARYWe analysed 112 idiopathic inflammatory myopathy (IIM) sera for the presence of anti-Ro, anti-La and anti-histidyl-tRNA synthetase (Jo-1) autoantibodies, and subsequently mapped B cell epitopes on the Ro52 protein recognized by anti-Ro52 þ IIM sera. Sera were characterized by immunoblotting, ELISA and RNA precipitation. Both anti-Ro60 and anti-La activity was found in 4% of IIM sera. Anti-Ro52 antibodies were present in 20% of IIM sera. However, in anti-Jo-1 þ IIM sera (21%), the frequency of the anti-Ro52 antibodies was found to be much higher (58%). No cross-reactivity between anti-Ro52 and anti-Jo-1 antibodies could be detected in these sera. To learn more about the nature of anti-Ro52 antibodies occurring in IIM sera, we analysed the major epitopes of the Ro52 protein targeted by antiRo52 þ IIM sera by immunoprecipitation of in vitro translated Ro52 deletion mutants. The major epitope was mapped in the region bordered by amino acids 126 and 252. This part of the protein includes a long a-helical region which contains two potential coiled-coil domains as well as a leucine zipper motif. Although no difference in Ro52 epitope recognition between anti-Jo-1 þ and anti-Jo-1 ¹ IIM sera could be observed, our results suggest that the autoimmune response against Ro52 and Jo-1 in IIM patients is coupled.

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Section: Introductionmentioning

confidence: 99%

Anti-Ro52 antibodies frequently co-occur with anti-Jo-1 antibodies in sera from patients with idiopathic inflammatory myopathy

Rutjes¹,

Egberts²,

Jongen³

et al. 1997

Clinical and Experimental Immunology

174

106

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“…The immunosuppressive agents such as azathioprine, methotrexate, cyclophosphamide, or cyclosporine have been increasingly used with corticosteroids in patients with rapidly progressive illness having serious extramuscular manifestations, disease relapses with the reduction of corticosteroids, serious corticosteroids-related complications, or the disease refractory to corticosteroids only (3). Because the prognosis of patients with IM relies on early diagnosis and treatment (8), the concomitant use of such agents with corticosteroids may be considered at an early stage of the disease.…”

Section: Discussionmentioning

confidence: 99%

Successful Combination Therapy of Cyclosporine and Methotrexate for Refractory Polymyositis with Anti-Jo-1 Antibody: A Case Report

Chang

Lee

2003

J Korean Med Sci

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Although corticosteroids have been the initial agent for the treatment of inflammatory myopathies (IM), immunosuppressive agents such as azathioprine, methotrexate, cyclophosphamide, or cyclosporine are commonly required to control the disease except mild cases. On the other hand, the efficacy of combination therapy of cyclosporine and methotrexate in severe rheumatoid arthritis has been proven without serious side effects. However, in treatment-resistant myositis, the experience of such a therapy is very limited, and has not been described in refractory polymyositis with anti-Jo-1 antibody. Here, we report a young female patient with recalcitrant polymyositis and anti-Jo-1 antibody who was successfully treated with the combination therapy of cyclosporine and methotrexate. At first, the myositis did not respond to several agents, such as corticosteroid, monthly pulse cyclophosphamide, azathioprine, or cyclosporine. Methotrexate was initially avoided as treatment regimen because of its potential pulmonary toxicity in the case with preexisting lung disease.

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“…IVIg has been re- ported to have anti-inflammatory effects and to help recovering muscle strength in patients with IBM and DM(ll, 12). There are somereports suggesting the usefulness of immunosuppressive agents such as prednisolone, azathioprine, methotrexate, cyclosporin and chlorambucil ( 1 3-15), especially if there is evidence of an associated systemic autoimmunediseases or autoantibodies (4,8,13,16). These drugs are often useful in steroid-resistant PM/DM,which occurs 10-40% of the patients (17,18).…”

Section: Discussionmentioning

confidence: 99%

Severe Inclusion Body Myositis with Interstitial Pneumonia.

et al. 2001

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Wereport a patient with a severe inclusion body myositis (IBM). His illness was unusual in terms of a rapid progression, high creatine kinase levels, and complication with interstitial pneumonia. He responded well to immunosuppressive agents such as corticosteroids, cyclosporin A, cyclophosphamide, and immunoglobulin. The present patient indicates the wide range of the disease, and that immunosuppressive agents may be useful for treatment of IBM. (Internal Medicine 40: 940-944, 2001)

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Drug therapy of the idiopathic inflammatory myopathies: predictors of response to prednisone, azathioprine, and methotrexate and a comparison of their efficacy

Cited by 274 publications

References 28 publications

Anti-Ro52 antibodies frequently co-occur with anti-Jo-1 antibodies in sera from patients with idiopathic inflammatory myopathy

Anti-Ro52 antibodies frequently co-occur with anti-Jo-1 antibodies in sera from patients with idiopathic inflammatory myopathy

Successful Combination Therapy of Cyclosporine and Methotrexate for Refractory Polymyositis with Anti-Jo-1 Antibody: A Case Report

Severe Inclusion Body Myositis with Interstitial Pneumonia.

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