Idiopathic Inflammatory Myopathies: Current and Future Therapeutic Options

Wiendl, Heinz

doi:10.1016/j.nurt.2008.08.008

Cited by 25 publications

(16 citation statements)

References 64 publications

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“…Accordingly, a fairly large dose of glucocorticoid has been concomitantly administered in previous studies or reports of IVIG therapy in PM [1][2][3]. From this perspective, our case can be considered exceptional, as we could not administer high doses of glucocorticoid according to the patient's request.…”

Section: Nakamura H Et Al Pagementioning

confidence: 83%

Long-term efficacy of intravenously administered immunoglobulin in a case of polymyositis with limited application of steroid therapy

Nakamura

Fujikawa²,

Kawakami

et al. 2010

Mod Rheumatol

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A 72-year-old man who had been diagnosed with polymyositis (PM) was admitted to our hospital for pneumonia with exacerbation of muscle weakness, elevation of muscle enzymes, and positive MRI findings. The patient had been refractory to cyclosporine A or azathioprine and hoped to avoid administration of high-dose steroids; intravenous immunoglobulin (IVIG) was therefore administered after improvement of the pneumonia. Two weeks after the IVIG therapy, muscle test scores, activities of daily living, and muscle enzymes were drastically improved. Twenty months after IVIG, no relapse of PM was observed.

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Section: Nakamura H Et Al Pagementioning

confidence: 83%

Long-term efficacy of intravenously administered immunoglobulin in a case of polymyositis with limited application of steroid therapy

Nakamura

Fujikawa²,

Kawakami

et al. 2010

Mod Rheumatol

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Section: Discussionmentioning

confidence: 99%

“…21,22 Of the immunosuppressive agents, the following are second-line treatment: azathioprine; cyclosporine; cyclophosphamide; and methotrexate. 22 There are no protocols defi ning the best treatment for DM. The medical assessment should be based individually on the severity of the clinical presentation, disease duration, presence of extramuscular manifestations, and contraindication to specifi c therapeutic agents.…”

Section: Discussionmentioning

confidence: 99%

Dermatomiosite em adulto: experiência de um centro terciário brasileiro

Souza¹,

Barros²,

Levy‐Neto³

et al. 2012

Rev. Bras. Reumatol.

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Objective: To report the results of a retrospective cohort involving 139 patients with dermatomyositis, conducted from 1991 to 2011. Methods: All patients met at least four of the fi ve Bohan and Peter criteria (1975). Results: The patients' mean age at disease onset was 41.7 ± 14.1 years, and mean disease duration was 7.2 ± 5.2 years. The sample comprised 90.2% white patients and 79.9% female patients. Constitutional symptoms occurred in less than half of the patients. Cutaneous and joint involvements occurred in 95.7% and 41.7% of the patients, respectively. Incipient pneumopathy, ground glass opacities and/or pulmonary fi brosis were present in 48.2% of the patients. All patients received prednisone (1 mg/kg/day) and 51.1% also received intravenous methylprednisolone (1 g/day for three days). Several immunosuppressants were used as corticosteroid sparing agents according to tolerance, side effects and/or refractoriness. Although disease relapse (clinical and/or laboratory) occurred in 53.2% of the patients, 76.3% were in disease remission at the end of the study. The rate of severe infection was 35.3%, and herpes zoster predominated. There were 15 (10.8%) cases of cancer, 12 within one year after the diagnosis. There were 16 deaths (11.5%), and their major causes were sepsis/septic shock (27.5%), pneumopathy attributed to the disease (31.3%), neoplasms (31.3%), and cardiovascular events (12.5%). Conclusions: In this study, the clinical and laboratory data were similar to those of other population groups described in the literature, with minimal differences regarding the frequency and characteristics of the extramuscular manifestations.

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“…43 Initial daily prednisone doses of up to 100 mg are used and are tapered according to clinical response, serum creatine kinase levels, and side effects. Methotrexate and azathioprine are used as steroid-sparing agents, often being initiated simultaneously with high-dose corticosteroids or because of inadequate response.…”

Section: Treatmentmentioning

confidence: 99%

Immunologic rheumatic disorders

Joseph

Brasington

Kahl

et al. 2010

Journal of Allergy and Clinical Immunology

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We provide the basics for clinicians who might be called on to consider the diagnosis of diseases such as systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA) in their practice. We will emphasize clinical recognition and first-line laboratory testing. Only characteristics of the classic rheumatic inflammatory diseases (ie, RA, seronegative spondyloarthropathy, SLE, antiphospholipid syndrome, Sjögren syndrome, scleroderma, and polymyositis/dermatomyositis) will be covered. In the past decade, treatment for RA and seronegative spondyloarthropathy has substantially improved. Their treatment has been revolutionized by the use of methotrexate and, more recently, TNF inhibitors, T-cell costimulation modulators, and B-cell depletion. The goal of RA treatment today is to induce a complete remission as early as possible in the disease process, with the mantra being "elimination of synovitis equals elimination of joint destruction." The hope is that if the major mediators of Sjögren syndrome, SLE, or scleroderma can be identified and then blocked, as in the example of TNF inhibitors in patients with RA, more specific treatments will become available. Thus RA has become an excellent model of this evolving paradigm. Through the identification of major mediators in its pathogenesis, novel and highly efficacious therapeutic agents have been developed.

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Idiopathic Inflammatory Myopathies: Current and Future Therapeutic Options

Cited by 25 publications

References 64 publications

Long-term efficacy of intravenously administered immunoglobulin in a case of polymyositis with limited application of steroid therapy

Long-term efficacy of intravenously administered immunoglobulin in a case of polymyositis with limited application of steroid therapy

Dermatomiosite em adulto: experiência de um centro terciário brasileiro

Immunologic rheumatic disorders

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