Methotrexate Treatment in Dermatomyositis

Sarova-Pinhàs, I; Siegal, T.; Turgman, J; Braham, J.

doi:10.1159/000114893

Cited by 12 publications

(4 citation statements)

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“…Methotrexate (MTX) is a folate inhibitor with a long immunosuppressive history for rheumatoid arthritis, and is therefore unfolding its effectiveness faster than AZA. MTX is a therapeutic option for severe PM/DM/NAM and in prednisolone refractory patients [ 64 , 65 ]. In addition, patients suffering from anti-synthetase syndrome with interstitial lung disease manifestations respond well to treatment with MTX [ 66 ].…”

Section: Conventional and Established Therapies For Iimmentioning

confidence: 99%

Scanning for Therapeutic Targets within the Cytokine Network of Idiopathic Inflammatory Myopathies

Paepe

Zschüntzsch

2015

IJMS

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The idiopathic inflammatory myopathies (IIM) constitute a heterogeneous group of chronic disorders that include dermatomyositis (DM), polymyositis (PM), sporadic inclusion body myositis (IBM) and necrotizing autoimmune myopathy (NAM). They represent distinct pathological entities that, most often, share predominant inflammation in muscle tissue. Many of the immunopathogenic processes behind the IIM remain poorly understood, but the crucial role of cytokines as essential regulators of the intramuscular build-up of inflammation is undisputed. This review describes the extensive cytokine network within IIM muscle, characterized by strong expression of Tumor Necrosis Factors (TNFα, LTβ, BAFF), Interferons (IFNα/β/γ), Interleukins (IL-1/6/12/15/18/23) and Chemokines (CXCL9/10/11/13, CCL2/3/4/8/19/21). Current therapeutic strategies and the exploration of potential disease modifying agents based on manipulation of the cytokine network are provided. Reported responses to anti-TNFα treatment in IIM are conflicting and new onset DM/PM has been described after administration of anti-TNFα agents to treat other diseases, pointing to the complex effects of TNFα neutralization. Treatment with anti-IFNα has been shown to suppress the IFN type 1 gene signature in DM/PM patients and improve muscle strength. Beneficial effects of anti-IL-1 and anti-IL-6 therapy have also been reported. Cytokine profiling in IIM aids the development of therapeutic strategies and provides approaches to subtype patients for treatment outcome prediction.

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Section: Conventional and Established Therapies For Iimmentioning

confidence: 99%

Scanning for Therapeutic Targets within the Cytokine Network of Idiopathic Inflammatory Myopathies

Paepe

Zschüntzsch

2015

IJMS

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“…Subsequently, a few case reports and retrospective reviews have also suggested that methotrexate may be effective in PM/DM [37,55,[60][61][62][63][64][65][66][67][68][69]. Firstly, Bohan et al [23] treated 25 patients with steroid-resistant PM/DM with methotrexate; 88% of these latter patients exhibited a significant PM/DM improvement and 43% of patients were able to reduce their steroid daily dose.…”

Section: Methotrexatementioning

confidence: 99%

Therapy of polymyositis and dermatomyositis

Marie

2011

La Presse Médicale

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“…13,14 Inadequate response to prednisone usually prompts the use of methotrexate, 51 but it has been used in combination with prednisone as a first-line therapy in severe myositis. 33,52 Response rates to methotrexate have ranged from 70% to 77% in patients needing adjunctive therapy. 23,25,53 A NIH study 23 found 31 of 55 patients treated with methotrexate after failure of corticosteroids partially responded, whereas 9 completely responded, showing an overall response rate of about 73%.…”

Section: Methotrexatementioning

confidence: 99%