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What are Inflammatory Myopathies?

What Causes Inflammatory Myopathies?

What are the Forms of Inflammatory Myopathies?

Can Inflammatory Myopathies be Cured?

How are PM, DM and IBM Diagnosed?

What Happens to Someone with Polymyositis?

What Happens to Someone with Dermatomyositis?

What Happens to Someone with Inclusion-Body Myositis?

Microscopic Myositis

PM and DM Treatments

MDA's Search for Treatments and Cures

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Medication or Treatment

How It Works

Comments

corticosteroids prednisone tablets (Deltasone);
intravenous methylprednisolone sodium
succinate
(Solu-Medrol)

Dampens inflammation and immune response by interfering with processing of antigens and with early triggering of T-cell and B-cell production and later proliferation of B-cells and T-cells. These cells are produced by the immune system in autoimmune diseases such as PM and DM.

Can be taken orally as prednisone and related compounds; also available for intravenous use.

Many side effects with long-term, high-dose therapy, such as weight gain and redistribution of fat to face, abdomen and upper back; thinning of skin; susceptibility to infection; bone loss; muscle damage; cataracts; elevated pressures in eyes (glaucoma); psychological disturbances; high blood pressure; high blood sugar; growth slowing in children.

azathioprine
(Imuran)

Interferes with proliferation of B-cells and T-cells.

Can suppress production of several types of blood cells, so cell counts must be monitored; increases risk of cancer.

methotrexate (Rheumatrex, Folex, Mexate)

Interferes with proliferation of B-cells and T-cells.

Can cause liver damage; used in higher doses to treat cancer.

cyclosporine
(Neoral, Sandimmune)

Keeps T-cells from stimulating production of more T-cells and B-cells (“upstream” of azathioprine and methotrexate action).

Doesn’t affect production of cells other than T-cells and B-cells; can cause kidney damage, infection, high blood pressure, tremor and excessive hair growth.

cyclophos-phamide
(Cytoxan)

Interferes with proliferation and activity of B-cells and T-cells.

Also used in cancer; toxic to many kinds of cells, including those of the blood and bladder; can cause sterility in both sexes.

mycophenolate mofetil
(CellCept)

Interferes with proliferation of B-cells and T-cells.

Can cause diarrhea, vomiting, infection (particularly with cytomegalovirus); increases risk of cancer, especially lymphomas; causes depletion of certain blood cells.

tacrolimus (Prograf, old name FK506)

Keeps T-cells from stimulating production of more T-cells and B-cells (“upstream” of azathioprine and methotrexate action).

Can damage kidneys; can cause headaches, tremors and sleep difficulties; diarrhea, nausea and vomiting; high blood pressure, high blood sugar and high blood levels of potassium; increases risk of infection and lymphomas.

Drug breakdown interfered with by grapefruit juice; potential for kidney damage increased by some anti-inflammatory drugs.

hydroxy-chloroquine sulfate
(Plaquenil)

Mechanism not understood; used in arthritis, lupus, malaria; can be used to reduce steroid dosage in myositis, particularly in children.

Can treat muscle symptoms and dermatomyositis rash.

Can cause damage to eyes’ retinas or corneas; regular eye exams needed.

infusion of mixed
immuno-
globulins; IVIg
(Gammar, Gammagard, Sandoglobulin,
others)

Has complex actions on immune system, such as providing antibodies against patient’s own antibodies; interfering with immune-system reaction to antibody-marked cells; interfering with blood-transported chemicals released by immune system; interfering with activation and maturation of T-cells and B-cells.

Doesn’t affect production of cells other than T-cells and B-cells; can cause kidney damage, infection, high blood pressure, tremor and excessive hair growth.

plasmapheresis

Removes antibodies and proteins made by the immune system from the blood and returns “cleansed” blood to patient.

Very rarely used in myositis since 1992 study showed it was no more effective than placebo; some think it’s useful when combined with immunosuppressant drugs.