TY - JOUR
T1 - Treatment of refractory polymyositis and dermatomyositis
AU - Ytterberg, Steven R.
PY - 2006/6
Y1 - 2006/6
N2 - 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.
AB - 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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U2 - 10.1007/s11926-996-0021-7
DO - 10.1007/s11926-996-0021-7
M3 - Article
C2 - 16901073
AN - SCOPUS:33747585796
SN - 1523-3774
VL - 8
SP - 167
EP - 173
JO - Current rheumatology reports
JF - Current rheumatology reports
IS - 3
ER -