Polymyositis and dermatomyositis medical therapy

Polymyositis and dermatomyositis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Polymyositis and dermatomyositis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Polymyositis and dermatomyositis medical therapy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Polymyositis and dermatomyositis medical therapy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Polymyositis and dermatomyositis medical therapy
CDC on Polymyositis and dermatomyositis medical therapy
Polymyositis and dermatomyositis medical therapy in the news
Blogs on Polymyositis and dermatomyositis medical therapy
Directions to Hospitals Treating Psoriasis
Risk calculators and risk factors for Polymyositis and dermatomyositis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

There is no treatment for [disease name]; the mainstay of therapy is supportive care.

OR

Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].

OR

The majority of cases of [disease name] are self-limited and require only supportive care.

OR

[Disease name] is a medical emergency and requires prompt treatment.

OR

The mainstay of treatment for [disease name] is [therapy].

OR   The optimal therapy for [malignancy name] depends on the stage at diagnosis.

OR

[Therapy] is recommended among all patients who develop [disease name].

OR

Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].

OR

Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].

OR

Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].

OR

Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].

Medical Therapy

• Pharmacologic medical therapies for polymyositis and dermatomyositis include corticosteroids, disease modifying antirheumatic drugs (DMARDs),

Polymyositis and dermatomyositis

• 1 Stage 1 - Initial treatment
  • 1.1 Corticosteroids
    • Preferred regimen (1): Prednisone 1 mg/kg PO qd (maximum 80 mg daily) for 4-6 weeks and then prednisone should be tapered over 26 weeks to reach 5 mg/d. Prednisone should be tapered by 10 mg every week until 40 mg/day then tapered by 5 mg every week until 20 mg/d then tapered by 2.5 mg every week until 10 mg/day then tapered by 1 mg every two weeks until the patient reaches 5 mg/day.
    • Preferred regimen (2): Methylprednisolone 1000 mg IV qd for 3 days
    • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
    • Alternative regimen (2): drug name 500 mg PO q12h for 14–21 days

Note (1): The side effects of corticosteroids include weight gain, redistribution of body fat, thinning of the skin, osteoporosis, cataracts, and muscle weakness. 

• 1.2 Disease modifying antirheumatic drugs (DMARDs) 

• Preferred regimen (1): Methotrexate
• Preferred regimen (1): Azathioprine
• Preferred regimen (1): Methotrexate
• Alternative regimen (1): Intravenous immunoglobulin (IVIg)
• Alternative regimen (1): Cyclosporine 
• Alternative regimen (1): Tacrolimus
• Alternative regimen (1): Mycophenolate mofetil
• Alternative regimen (1): Rituximab

• 2 Stage 2 - Resistant
  • 2.1