Treatment of refractory myositis: A randomized crossover study of two new cytotoxic regimens

Villalba, Lourdes; Hicks, Jeanne E.; Adams, Elizabeth M.; Sherman, Jeffrey B.; Gourley, Mark F.; Leff, Richard L.; Thornton, Bonnie C.; Burgess, Suzanne H.; Plötz, Paul H.; Miller, Frederick W.

doi:10.1002/1529-0131(199803)41:3<392::aid-art3>3.3.co;2-o

Cited by 109 publications

(25 citation statements)

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“…Moreover, the bene®t of combining methotrexate with azathioprine was suggested in patients who previously revealed inadequate responses to either methotrexate or azathioprine alone (7). However, concerning our patient, we avoided the combination therapy with these drugs due to an increased risk of hepatotoxicity or gastrointestinal intolerance noted in previous studies (7,8).…”

Section: Discussionmentioning

confidence: 73%

Combined use of cyclosporine A and methotrexate in refractory polymyositis: CASE REPORT

Mitsunaka

Tokuda²,

Hiraishi³

et al. 2000

Scandinavian Journal of Rheumatology

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Polymyositis is an inflammatory muscle disease with unknown cause that is characterized by progressive weakness of the proximal muscles. Limited information is available concerning the effectiveness of the combination therapy with cyclosporine A and methotrexate in reducing myositis activity. We describe here a female patient with polymyositis who showed resistance to pulse corticosteroid therapy. Neither the combination of azathioprine (100 mg/day) nor methotrexate (10 mg/week) with corticosteroids decreased the value of creatine phosphokinase. Normalization of the creatine phosphokinase level as well as improvement of muscle strength was obtained only when low-dose cyclosporine A (3 mg/kg/day) was combined with methotrexate.

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Section: Discussionmentioning

confidence: 73%

Combined use of cyclosporine A and methotrexate in refractory polymyositis: CASE REPORT

Mitsunaka

Tokuda²,

Hiraishi³

et al. 2000

Scandinavian Journal of Rheumatology

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“…An open-label trial suggested that combination methotrexate and azathioprine may benefit patients who had not responded adequately to either agent alone 33. Given the complementary modes of action of many agents, and preliminary evidence of efficacy of combination treatment in other autoimmune diseases, this should be a promising area of research in the future.…”

Section: Management Of Myositismentioning

confidence: 99%

New approaches to the assessment and treatment of the idiopathic inflammatory myopathies

Miller

2012

Ann Rheum Dis

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The rarity and heterogeneity of the idiopathic inflammatory myopathies (IIM), and the few validated assessment tools available, have limited information to guide the management of patients with polymyositis, dermatomyositis or inclusion body myositis. In light of the need for such tools, the International Myositis Assessment and Clinical Studies Group (IMACS) was formed as a multidisciplinary consortium of rheumatologists, neurologists, dermatologists, physiatrists and other myositis experts to develop consensus and standards for the conduct and reporting of myositis studies, and to facilitate myositis research. IMACS has developed consensus core set measures of disease activity, disease damage and patient-reported outcomes, and compiled a preliminary definition of improvement. The IMACS tools assist in the evaluation of the extent of disease activity and damage, although other approaches--including key clinical features, laboratory tests, muscle T1 and short τ inversion recovery MRI and immunological markers--are also helpful. Clinical remission is a realistic objective for most patients and should be pursued aggressively to optimise outcomes. Physical therapy and rehabilitation should be applied early and consistently to achieve optimal strength and function. Treatments that have been developed for other immune-mediated diseases are also being used and tested in the IIM, and some have shown anecdotal evidence of benefit. Recent advances in understanding the pathogenesis of myositis, development of assessments and treatments for other diseases that can be applied to myositis, and international collaborations and consensus standards for evaluating the IIM, all promise improvements in the assessment and treatment of myositis in the future.

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“…26 Retrospective studies, open prospective studies, and case reports have indicated a positive effect of MTX on muscle function in steroid-resistant patients with DM/PM, 56,57 but there have been no prospective controlled studies of this agent. 60 The efficacy of CyX in IIM is unclear. In an additional open retrospective study, male patients with myositis with Jo-1 antibodies with incomplete clinical response to glucocorticoids were reported to have a more favorable clinical response to additional treatment with MTX compared with AZA.…”

Section: Immunosuppressive Agentsmentioning

confidence: 99%

Targeted Treatment of the Idiopathic Inflammatory Myopathies

Dastmalchi¹,

Alexandersson²

2010

Targeted Treatment of the Rheumatic Diseases

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Treatment of refractory myositis: A randomized crossover study of two new cytotoxic regimens

Cited by 109 publications

References 0 publications

Combined use of cyclosporine A and methotrexate in refractory polymyositis: CASE REPORT

Combined use of cyclosporine A and methotrexate in refractory polymyositis: CASE REPORT

New approaches to the assessment and treatment of the idiopathic inflammatory myopathies

Targeted Treatment of the Idiopathic Inflammatory Myopathies

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