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Treatments for Dermatomyositis (DM) and Polymyositis (PM)

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Overview
Biological Agents
Combination Therapies
Exercise
Immunosuppressants
IVIg
Stem Cell Transplants

Overview

Treatments for polymyositis and dermatomyositis include biological agents, exercise, immunosuppressants, steroids, IVIg, and stem cell transplants. (Also see Autoimmune Diseases, and Dermatomyositis/Polymyositis)

Biological Agents

Rituximab for refractory rapidly progressive interstitial lung disease (RP–ILD) related to anti-MDA5 antibody–positive amyopathic dermatomyositis. Our results suggest that RTX may be a useful therapy for anti-MDA5 Ab-positive ADM associated with RP–ILD, although infection is the major risk. PubMed, Clin Rheumatol, 04/30/2018. (Also see Biologic Agents)

The Use of Rituximab in the Management of Refractory Dermatomyositis. This is a retrospective study of 25 patients with dermatomyositis who were treated with rituximab. PubMed, J Drugs Dermatol. 2017 Feb 1;16(2):162-166.

Combination Therapies

(Expired Article) Dermatomyositis and Polymyositis Associated with Malignancy: A 21-year Retrospective Study. In patients with tumor-associated myositis, it was more frequently necessary to administer other immunosuppressive drugs along with glucocorticoids. J Rheumatol .

Exercise

Physical exercise as a treatment for adult and juvenile myositis. These data suggest that intensive aerobic exercise and resistance training could reduce disease activity and inflammation and improve muscle metabolism. PubMed, J Intern Med, 2016 Jul;280(1):75-96.

Immunosuppressants

How is Polymyositis Treated? Initially, polymyositis is treated with high doses of corticosteroids. MedicineNet.com.

The efficacy of tacrolimus in patients with refractory dermatomyositis/polymyositis (DM/PM): a systematic review. Current evidence appears to support the use of tacrolimus in refractory PM/DM and PM/DM-ILD patients and it seems to be a safe drug that improves both muscle strength and lung function, and is well tolerated by patients. PubMed, Clin Rheumatol, 09/02/2015.

Intravenous Immunoglobulin (IVIg)

Case Report: Intravenous Immune Globulin in Amyopathic Dermatomyositis (ADM) – Report of Two Cases and Review of the Literature. We present both cases in describing IVIG as a rescue and maintenance steroid–sparing agent in the treatment of severe refractory ADM. PubMed, Open Rheumatol J.

Successful Treatment With Intravenous High-Dose Immunoglobulin For Cardiomyopathy In Dermatomyositis Complicated With Rapid Progressive Interstitial Pneumonia And Macrophage Activation Syndrome. This is the first report that IVIg may be effective for cardiomyopathy in dermatomyositis. ATS Journal.

Stem Cell Transplants

Stem cell transplantation in myositis. The aim of this clinical trial from 2005-2015 is to test whether it is safe to transplant stem cells from the blood into patients with myositis whose condition has not responded to conventional treatments. Muscular Dystrophy Campaign.

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