The Effect of Methylprednisolone Pulse Therapy in Polymyositis/Dermatomyositis

Boloşiu, H D; Man, Lin; Rednic, Simona

doi:10.1007/978-1-4615-4857-7_54

Cited by 25 publications

(10 citation statements)

References 7 publications

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“…Seven JDM patients treated within 3 months of onset of weakness with IVMP, 30 mg/kg/day for 3 days, repeated weekly for 1 to 4 weeks had incomplete response of weakness and oral steroids had to be added in five patients. A case series of seven adult patients with severe refractory PM or DM treated with daily pulses of IVMP, 0.5 gram 3 days/month for 3 months, found improvement in all patients but the report did not describe other therapies that were given [19].…”

Section: Intravenous Methylprednisolone Pulsesmentioning

confidence: 93%

Treatment of refractory polymyositis and dermatomyositis

Ytterberg

2006

Curr Rheumatol Rep

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Polymyositis (PM) and dermatomyositis (DM) are autoimmune inflammatory diseases that primarily target muscle. Although similar, PM and DM have different pathophysiologic mechanisms. Current therapy for PM and DM does not take into account these pathophysiologic differences. Recent work has started to define outcome measures to apply to future therapeutic trials, which will allow better comparison of treatment outcomes. For patients who are unresponsive to standard therapy with high dose prednisone supplemented by methotrexate and/or azathioprine it is not clear what represents the next best choice for therapy. Although there are few controlled studies in the area, there is reason to be optimistic for use of intravenous methylprednisolone pulses, intravenous gammaglobulin, cyclosporine A, tacrolimus, mycophenolate mofetil, and rituximab for nonresponding patients. Better understanding of the underlying pathophysiology of PM and DM, as well as carefully performed multicenter clinical trials is going to be necessary to make better recommendations in the future.

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Section: Intravenous Methylprednisolone Pulsesmentioning

confidence: 93%

Treatment of refractory polymyositis and dermatomyositis

Ytterberg

2006

Curr Rheumatol Rep

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“…Literature review and analysis. Although they have not been tested in controlled clinical trials, GC represent first-line drugs in the treatment of SAM with recommended initial doses of 0.5 to 1.0 mg/kg/day of prednisone for at least 4 weeks (C) [41][42][43]. (Fig.…”

Section: How Long Should Sam Patients Receive Immunosuppressive / Immmentioning

confidence: 99%

“…CK creatine phosphokinase, GC glucocorticoid, IMACS International Myositis Assessment and Clinical Studies Group, SAM systemic autoimmune myopathies, SAM systemic autoimmune myopathies, TNF tumor necrosis factor (MP) pulse therapy (1 g/day for three consecutive days) followed by a high dose of GC via oral route should be considered (C) [44] (B) [41].…”

Section: How Long Should Sam Patients Receive Immunosuppressive / Immmentioning

confidence: 99%

“…GC typically results in the normalization of serum levels of muscle enzymes and clinical improvement in muscle strength. However, more than half of patients (B) [49] do not present a complete response to the use of these drugs, and several factors may contribute to response to treatment including disease subtype, onset of therapy, antibody profile or the presence of cancer [41].…”

Section: How Long Should Sam Patients Receive Immunosuppressive / Immmentioning

confidence: 99%

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Guidelines of the Brazilian Society of Rheumatology for the treatment of systemic autoimmune myopathies

et al. 2019

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Background: Recommendations of the Myopathy Committee of the Brazilian Society of Rheumatology for the management and therapy of systemic autoimmune myopathies (SAM). Main body: The review of the literature was done in the search for the Medline (PubMed), Embase and Cochrane databases including studies published until June 2018. The Prisma was used for the systematic review and the articles were evaluated according to the levels of Oxford evidence. Ten recommendations were developed addressing the management and therapy of systemic autoimmune myopathies. Conclusions: Robust data to guide the therapeutic process are scarce. Although not proven effective in controlled clinical trials, glucocorticoid represents first-line drugs in the treatment of SAM. Intravenous immunoglobulin is considered in induction for refractory cases of SAM or when immunosuppressive drugs are contra-indicated. Consideration should be given to the early introduction of immunosuppressive drugs. There is no specific period determined for the suspension of glucocorticoid and immunosuppressive drugs when individually evaluating patients with SAM. A key component for treatment in an early rehabilitation program is the inclusion of strengthbuilding and aerobic exercises, in addition to a rigorous evaluation of these activities for remission of disease and the education of the patient and his/her caregivers.

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“…Patients with severe disease manifestations such as marked weakness, severe dysphagia or rapidly progressive interstitial lung disease require pulse intravenous methylprednisolone (1000 mg daily for three consecutive days) followed by the high-dose oral glucocorticoid regimen given above [12]. These patients generally should be started on a steroid-sparing immunosuppressive drug.…”

Section: Glucocorticoid Therapymentioning

confidence: 99%

Treatment of inflammatory myopathy: emerging therapies and therapeutic targets

Moghadam-Kia

Aggarwal

Oddis³

2015

Expert Review of Clinical Immunology

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Despite the lack of placebo-controlled trials, glucocorticoids are considered the mainstay of initial treatment for idiopathic inflammatory myopathy and myositis-associated interstitial lung disease. Glucocorticoid-sparing agents are often given concomitantly with other immunosuppressive agents, particularly in patients with moderate or severe disease. First-line conventional immunosuppressive drugs include either methotrexate or azathioprine, and when they fail, more aggressive therapy includes mycophenolate mofetil, tacrolimus or cyclosporine, intravenous immunoglobulin, rituximab, or cyclophosphamide, used alone or in various combinations. Further investigations are required to assess the role of more novel therapies in the treatment of myositis and myositis-associated interstitial lung disease.

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The Effect of Methylprednisolone Pulse Therapy in Polymyositis/Dermatomyositis

Cited by 25 publications

References 7 publications

Treatment of refractory polymyositis and dermatomyositis

Treatment of refractory polymyositis and dermatomyositis

Guidelines of the Brazilian Society of Rheumatology for the treatment of systemic autoimmune myopathies

Treatment of inflammatory myopathy: emerging therapies and therapeutic targets

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