Materiały źródłowe

• #1 Polymyositis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/polymyositis/diagnosis-treatment/drc-20353212

  Although there’s no cure for polymyositis, treatment can improve your muscle strength and function. The earlier treatment is started in the course of polymyositis, the more effective it is leading to fewer complications. […] However, as with many conditions, no single approach is best; your doctor will tailor your treatment strategy based on your symptoms and how well they respond to therapy. […] The most commonly used medications to treat polymyositis include: […] Corticosteroids. Drugs such as prednisone can be very effective in controlling polymyositis symptoms. But prolonged use of these drugs can have serious and wide-ranging side effects, which is why your doctor may gradually taper the dose of medication down to lower levels. […] Corticosteroid-sparing agents. When used in combination with a corticosteroid, these drugs can decrease the dose and potential side effects of the corticosteroid. The two most common medications used for polymyositis are azathioprine (Azasan, Imuran) and methotrexate (Trexall). Other medications prescribed for polymyositis include mycophenolate mofetil (CellCept), cyclosporine and tacrolimus.

• #1 Polymyositis Treatment & Management: Approach Considerations, Extramuscular Manifestations of Polymyositis, Inpatient and Outpatient Care

  https://emedicine.medscape.com/article/335925-treatment

  Treatment of polymyositis (PM) is empirical because of the rarity of the disease and the paucity of randomized controlled trials. Established options include corticosteroids and immunosuppressants; limited data support the use of other agents. […] Prednisone is the first-line treatment of choice for polymyositis. Typically, the dose is 1 mg/kg/day, either as a single dose or in divided doses. This high dose is usually continued for 4-8 weeks, until the creatine kinase (CK) level returns to reference ranges. Taper prednisone by 5-10 mg on a monthly basis until the lowest dose that controls the disease is reached. […] Monitor response to therapy based on improvement in muscle strength and muscle endurance and decrease in CK levels. Closely monitor patients with polymyositis for disease activity and adverse effects of corticosteroids, such as weight gain, hypertension, diabetes mellitus, osteopenia, and steroid myopathy.

• #1 Evaluation and Management of Polymyositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3482800/

  Polymyositis (PM) is one of the inflammatory myopathies, disorders characterized pathologically by the presence of inflammatory infiltrates in striated muscle. […] Corticosteroids and immunosuppressive agents are the mainstays of therapy for PM. The principal goals of therapy are to improve strength and improve physical functioning. […] The mainstays of therapy are corticosteroids and other immunosuppressive drugs. Adjunctive, non-pharmacologic therapies are also important. These include exercise regimens appropriate to strength, measures to prevent aspiration, and general supportive care. […] Corticosteroids like prednisone are the first line of therapy for PM. The usual starting dose is 1 mg/kg/day of prednisone or its equivalent. […] After the initial 6-8 weeks, a slow taper of steroids should begin. The goal is to taper steroids off or to the lowest possible effective dose over a period of 9-12 months.

• #1 Polymyositis (PM) – Muscular Dystrophy UK

  https://www.musculardystrophyuk.org/conditions/a-z/polymyositis-pm/

  Polymyositis is often first treated with corticosteroid tablets, such as prednisolone. Steroids reduce the activity of the immune system. Prednisolone is usually started at a high dose and can be given as tablets, injection, or by infusion. The dose is then gradually lowered based on the persons response and improvement in symptoms. Not everyone with polymyositis needs steroids and if the condition is mild, disease-modifying anti-rheumatic drugs (DMARDs) alone may be enough. In the long term, steroids can cause side effects such as increased risk of infections, high blood pressure, fragile skin which bruises easily, weight gain, cataracts, and weakened bones (osteoporosis). Regular monitoring and additional medications can help manage these risks but the best way to avoid side effects is to gradually reduce the dose, aiming to eventually come off steroid treatment or to take the lowest required dose. Do not stop taking steroids suddenly, as this is dangerous and has serious health risks. Its important to carry a Steroid Emergency Card, as it provides important information for healthcare professionals in an emergency. The card can be obtained from a GP, community pharmacy, or specialist hospital team.

• #1 Polymyositis – Myositis Support and Understanding

  https://understandingmyositis.org/myositis/polymyositis/

  The goals of treatment for polymyositis are to eliminate or reduce inflammation, restore muscle performance, reduce morbidity, and improve a patients quality of life. […] There are no approved therapies for polymyositis, aside from steroids, which are not recommended for long-term use. […] Finding a combination of medications is often necessary for successful results. […] The initial treatment is typically corticosteroids such as prednisone or prednisolone and may be dosed by the patients weight at 1 mg per kg. […] Corticosteroids address inflammation and simultaneously help suppress the overactive immune system. […] Additional drugs to suppress the immune system are frequently added to the steroids, sometimes at the beginning of treatment and other times once the determination has been made that steroids have shown to be effective.

• #1 Polymyositis Treatment & Management: Approach Considerations, Extramuscular Manifestations of Polymyositis, Inpatient and Outpatient Care

  https://emedicine.medscape.com/article/335925-treatment

  Immunosuppressive agents are indicated in patients who do not improve with steroids within a reasonable period (ie, 4 wk) or in whom adverse effects from corticosteroids develop. Patients with poor prognostic indicators, such as dysphagia or dysphonia, are likely to require immunosuppressive agents. Under these circumstances, methotrexate is the second-line agent. […] Intravenous immunoglobulin (IVIG) has been used for the short-term treatment of steroid-resistant cases of polymyositis. A systematic review and meta-analysis concluded that treatment with IVIG can improve muscle strength, creatine kinase levels, and esophageal involvement, and it is well tolerated. […] The anti-CD20 monoclonal antibody rituximab may be an approach to therapy for refractory cases. The benefit of rituximab was demonstrated in the Rituximab in Myositis (RIM) study, the largest randomized trial ever completed in myositis.

• #1 Evaluation and Management of Polymyositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3482800/

  In a steroid responsive patient, the goal is to attain the lowest dose of steroids that will adequately manage the disease. In order to achieve this goal, steroid-sparing agents are necessary in most PM patients. […] Mycophenolate mofetil is administered orally in doses up to 3 g/day. […] Cyclosporine A and tacrolimus have both shown some efficacy in the treatment of refractory PM. […] In patients who are corticosteroid resistant, especially where there is rapidly progressive or life-threatening progression, intravenous immunoglobulin (IVIG) may be helpful. […] Rituximab (RTX) is a monoclonal antibody against CD 20 positive B-cells, which causes depletion of these cells for 6 months or longer. […] Cyclophosphamide (CTX) is an alkylating agent that is toxic to lymphopoietic cells. Both T-cells and antibody producing B-cells are affected. CTX has considerable hematologic and bladder toxicity, and is a potent immunosuppressive.

• #1 Polymyositis Treatment & Management: Approach Considerations, Extramuscular Manifestations of Polymyositis, Inpatient and Outpatient Care

  https://emedicine.medscape.com/article/335925-treatment

  The calcineurin inhibitor tacrolimus appears to be effective, safe, and well tolerated in patients with polymyositis that is refractory to other treatments. […] Mycophenolate mofetil has been reported in case reports to be effective. […] Adrenocorticotropic hormone (ACTH) gel has shown some promise in case series with improvement in muscle as well as skin disease. Further randomized trials are required. […] Patients with polymyositis may benefit from a high-protein diet. Monitor patients to avoid excessive weight gain due to corticosteroid use. […] Encourage patients with polymyositis to start a supervised exercise program early in the disease course. […] Once acute inflammation is under control, the rehabilitation program should include active range-of-motion exercises and isometric contractions of the muscle groups. With improvement in muscle strength, patients should perform isotonic exercises with light resistance. Encourage patients to do 15-30 minute sessions of aerobic exercise when the disease is inactive.

• #1 Polymyositis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563129/

  Polymyositis is treated with a combination of different pharmacological and non-pharmacological modalities. Pharmacological treatment mainly includes corticosteroids. Prednisone and methylprednisolone are the most common corticosteroids used for polymyositis, with a starting dose of 1 mg/kg of prednisone a day. The steroids are tapered off gradually and not withdrawn suddenly. The second-line treatment option includes the use of immune modulators (methotrexate, azathioprine, cyclosporine) in those patients who either do not respond to steroids or develop severe adverse effects due to steroid usage. Cyclophosphamide, an immune modulator, works efficiently, especially in patients with the involvement of the pulmonary interstitium. In the case of chronic refractory polymyositis, intravenous immunoglobulins (IVIG) can be used. A study showed improvement in around 70% of the patients after using IVIG. […] IVIG also shows significant improvement in patients with dysphagia due to esophageal involvement. Certain biologics, such as infliximab and etanercept, have been used in treating refractory cases of PM. Other therapies include tacrolimus, a calcineurin inhibitor that has proven to be beneficial in patients with refractory disease with simultaneous use of prednisolone. Mycophenolate mofetil and the anti-CD20 monoclonal antibody rituximab have also been found to be useful in treating refractory cases of polymyositis.

• #1 A Case of Refractory Polymyositis Successfully Treated With Abatacept Monotherapy | Volume 35 – Issue 4 – December 2020 | Archives of Rheumatology

  https://tjr.org.tr/full-text/1127

  Use of biological agents is recommended in cases refractory to the conventional treatment of PM. […] The administration of abatacept monotherapy in patients with PM may be considered as a treatment option because it allows for monotherapy in patients with PM that cannot be managed with biological or other immunosuppressive agents and develop adverse effects because of corticosteroids. […] In conclusion, abatacept monotherapy can safely be used in patients with PM that do not respond to conventional treatment or develop treatment-related complications, with due consideration given to the pathogenesis of the disease and the action mechanism of the agent.

• #1 Polymyositis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/polymyositis/diagnosis-treatment/drc-20353212

  Rituximab (Rituxan). More commonly used to treat rheumatoid arthritis, rituximab is an option if initial therapies don’t adequately control your polymyositis symptoms. […] Depending on the severity of your symptoms, your doctor might suggest: […] Physical therapy. A physical therapist can show you exercises to maintain and improve your strength and flexibility and advise an appropriate level of activity. […] Speech therapy. If your swallowing muscles are weakened by polymyositis, speech therapy can help you learn how to compensate for those changes. […] Dietetic assessment. Later in the course of polymyositis, chewing and swallowing can become more difficult. A registered dietitian can teach you how to prepare easy-to-eat, nutritious foods. […] Intravenous immunoglobulin (IVIg) is a purified blood product that contains healthy antibodies from thousands of blood donors. These healthy antibodies can block the damaging antibodies that attack muscle in polymyositis. Given as an infusion through a vein, IVIg treatments may need to be repeated regularly for the effects to continue.

• #1 Polymyositis | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/polymyositis

  Treatment options include corticosteroids, immunosuppressive drugs and physical therapy. […] Treatment options include: […] Corticosteroids used to dampen the activity of the immune system and reduce inflammation. For some people, corticosteroids contribute to muscle weakness, so other medications have to be used instead. […] Immunosuppressive drugs include drugs such as azathioprine and methotrexate. […] Plasmapheresis the antibodies responsible for attacking muscle tissue are removed from the bloodstream by plasmapheresis. Blood is taken from the patient and the blood cells are separated from the plasma. Only the blood cells are returned to the patient, leaving the antibodies behind in the plasma. […] Immunoglobulin a special protein obtained from the plasma of blood donors, and administered intravenously, has sometimes had good results in difficult cases. […] Physical therapy helps strengthen muscles. […] Ongoing monitoring includes blood tests, so that medications can be adjusted if necessary. Generally, the initial doses are high, then gradually tapered down.

• #1 Myositis: Muscle Inflammation | Inflammatory Myopathy | HSS

  https://www.hss.edu/condition-list_myositis.asp

  There is no cure for myositis, but most patients can manage their symptoms. […] Treatment of myositis should always include regular exercise and physical therapy, but may also include immunosuppressive medications like steroids, methotrexate, azathioprine, or mycophenolate. […] Intravenous infusions of immune globulin or rituximab can be used in some cases. […] The pace of research in this area continues to accelerate, hopefully leading to more therapies and better outcomes for myositis patients. […] It is somewhat counterintuitive to recommend exercise to myositis patients, whose muscle is already injured by their immune system. […] However, recent research has shown that physical therapy can help maintain and improve muscle function in myositis patients, without significant risk of harm.

• #1 Polymyositis

  https://www.physio.co.uk/what-we-treat/rheumatology/polymyositis.php

  Polymyositis is an autoimmune condition that causes inflammation and pain in a number of muscles in the body. […] Although there is no cure for polymyositis, it is important that the symptoms remain under control so you are able to continue with your normal activities of daily living. Physiotherapy is an effective way to minimise your symptoms and help you lead an active and healthy lifestyle. […] Your physiotherapist at Physio.co.uk will tailor your treatment programme to specifically manage your symptoms. […] It is important to begin your physiotherapy programme as soon as you have a diagnosis of polymyositis to give you the best possible outcome of your treatment. […] Physiotherapy can help manage the symptoms of polymyositis in a number of ways. […] Your physiotherapist at Physio.co.uk will provide you with a full assessment which can then help create an individualised treatment programme to minimise any difficulties you were having.

• #1 Polymyositis

  https://healthlibrary.gradyhealth.org/Conditions/Pregnancy/134,45

  Physical therapy. This treatment includes special exercises that help to stretch and strengthen the muscles. They can help keep muscles from shrinking. […] Heat therapy and rest. These can help ease muscle symptoms. […] Braces or other special devices. These can help to support muscles and help with movement. […] Talk with your healthcare provider about the risks, benefits, and possible side effects of all medicines. […] Although polymyositis can’t be cured, its symptoms can be managed.

• #1 Polymyositis

  https://www.physio.co.uk/what-we-treat/rheumatology/polymyositis.php

  The types of physiotherapy that may be used include strengthening exercises, range of movement exercises, hydrotherapy, TENS, cardiovascular activity, pain control modalities, pacing advice, and provision of specialist equipment to help at home. […] Physiotherapy is very helpful in managing these symptoms and allowing you to maintain an active lifestyle.

• #1 Supervised Physical Therapy and Polymyositis/Dermatomyositis—A Systematic Review of the Literature

  https://www.mdpi.com/2035-8377/12/3/15

  Supervised physical therapy in polymyositis/dermatomyositis is an effective, safe and free-of-contraindications tool to be used both in the acute and in the established phases of the pathology. […] Therapy for DM and PM usually begins with high-dose oral prednisone (1 mg/kg/day), which should be subsequently tapered off slowly based on patients’ clinical response. Intravenous immunoglobulins are a viable treatment option as second-line therapy. […] Physical therapy has progressively acquired a central role in the management of neuromuscular disorders. […] The purposes of this systematic review were (a) to verify the safety and efficacy of supervised PT in people with PM/DM and (b) to provide a clear indication of the different types of exercises in the management of PM/DM. […] The reviewed studies also stated that supervised PT has an adjuvant effect on immunosuppressive drug therapy. […] In conclusion, supervised PT has been found to be a safe and effective tool in the management of patients with PM/DM, both active or established, with no contraindications or known adverse effects.

• #1 Physical Therapy for Myositis Patients: Strength & Mobility

  https://www.hss.edu/conditions_physical-therapy-and-myositis.asp

  Ms. Yanelli shared studies that demonstrated evidence-based research on the positive effects of exercise for people with dermatomyositis (DM) and polymyositis (DM). […] One study, called the Effects of Physical Exercise Shortly on an Acute Episode of Dermatomyositis/Polymyositis, found that: Physical training begun 2-3 weeks after an acute exacerbation of DM/PM seems to be safe and useful. Muscle atrophy, due to lack of activity, may be partially prevented. Level of disability can be decreased. […] In a study of DM/PM patients on the benefits of intensive aerobic training it was found that: There was improvement in strength, balance, performance in activities of daily living, and walking speed. […] In a further study investigating the benefits of intensive muscular training in patients with DM/PM, it was concluded that: Patients with chronic, stable DM and PM can perform intensive resistive exercise as described in this study – with the approval of a physician. Results may include reduced impairment and an increase in activity level without increased muscle inflammation.

• #1 Polymyositis and Dermatomyositis Causes, Symptoms, Treatment, Prevention

  https://www.medicinenet.com/polymyositis/article.htm

  Physical therapy with gradual muscle strengthening is an important part of the treatment of polymyositis. When to begin and the continued degree of exercise and range of motion of extremities is customized for each patient. […] Patients can ultimately do well, especially with early medical treatment of disease and disease flares. The disease frequently becomes inactive, and rehabilitation of atrophied muscle becomes a long-term project. Monitoring for signs of cancer, heart, and lung disease is essential. […] As mentioned above, the related muscle disease called inclusion body myositis is often more resistant to treatment than polymyositis. As scientists better define the specific causes of the different forms of polymyositis, treatment will be more accurately aimed at the cure of this disease. Researchers are finding more specific antibodies in patients that may be used to diagnose and define the active disease. […] The best home remedy is to closely monitor the condition with the physician and physical therapist. It is best to not over-exercise early on but gradually increase exercise for optimal results.

• #1 Polymyositis: Causes, Symptoms, and Treatment

  https://www.webmd.com/arthritis/polymyositis

  Polymyositis is a chronic condition. That means that once you have it, it sticks around. But there are ways to help manage it. […] These medications can help with polymyositis: […] Corticosteroids. These are the first medicines used to treat polymyositis. They lower inflammation and ease pain. […] Drugs that suppress the immune system (immunosuppressants). These medicines help your immune system stop attacking your body’s tissues. There are many different kinds of immunosuppressants, such as azathioprine (Imuran and Azasan), methotrexate (Rheumatrex and Trexall), and rituximab (Rituxan). […] In addition to medicine, your doctor may also suggest some of these therapies, depending on your symptoms: […] Physical therapy. A physical therapist will guide you through helpful exercises. These exercises will make you stronger and help you move better.

• #1 Polymyositis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/335925-overview

  Polymyositis is an idiopathic inflammatory myopathy characterized by the following: Progressive symmetric, predominantly proximal muscle weakness; Elevated skeletal muscle enzyme levels; Characteristic electromyography (EMG) and muscle biopsy findings. […] Treatment of polymyositis is empirical because of the rarity of the disease and the paucity of randomized controlled trials. Prednisone is the first-line treatment of choice. Immunosuppressive agents are indicated in patients who do not improve within a reasonable period (ie, 4 wk) or in whom adverse effects from corticosteroids develop. Limited data support the use of other agents. […] Patients with polymyositis should be educated early about the disease, its complications, and treatment options and should be provided with realistic expectations about outcomes. Most patients show significant improvement with treatment. Stress the need for close follow-up care, continued physical therapy, and long-term therapy with monitoring of several parameters including medication toxicity and screening for malignancy.

• #1 Polymyositis: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12053-polymyositis

  Polymyositis is a rare autoimmune disease that makes your immune system attack your muscles. […] Experts arent certain what causes polymyositis, and theres no cure for it. A healthcare provider will treat the symptoms youre experiencing and suggest ways to manage how much they affect your daily routine. […] Theres no cure for polymyositis. Your provider will suggest treatments to manage the inflammation. Treatments cant make the polymyositis go away, but it can reduce how much symptoms affect your day-to-day life. Many people reach a period of remission (when theres no inflammation in your affected muscles). […] The most common treatments for polymyositis include: Corticosteroids: Prescription anti-inflammatory medications. Immunosuppressants: Medications that reduce your immune systems activity and reduce how much it damages your muscles. Intravenous immunoglobulin (IVIG): Extra antibodies your provider will inject into one of your veins. IVIG can redirect your immune system so it cant attack your bodys tissue. IVIG acts like a distraction. If your immune system is focused on going after the IVIG antibodies, it wont damage your muscles as much. Physical therapy: Your provider or a physical therapist will give you stretches and exercises to keep your affected muscles flexible and strong. Physical therapy can strengthen your affected muscles and reduce how much youre affected by future polymyositis episodes.

• #1 Medical Management – Polymyositis (PM) – Diseases | Muscular Dystrophy Association

  https://www.mda.org/disease/polymyositis/medical-management

  Polymyositis (PM) is a highly treatable disease. Drugs that suppress the immune system (immunosuppressive drugs) are the mainstay of therapy. […] Glucocorticoids, particularly prednisone, are often the first-line treatment. These medications help to reduce inflammation and swelling, and suppress damaging autoimmune responses. […] For some affected people, therapy with other immunosuppressive drugs, such as azathioprine, methotrexate, mycophenoloate mofetil, tacrolimus, or cyclosporine may be beneficial. Additional treatment options used in combination may include the monoclonal antibody rituximab or intravenous immunoglobulin (IVIG). […] Treatment plans are typically individualized to meet the needs of the affected person and ongoing monitoring is required to optimize the treatment protocol. In some cases, affected people may require prolonged maintenance therapy throughout their lives, while in others, therapy may be gradually withdrawn as symptoms resolve. Some people recover completely, while others experience greatly diminished symptoms for long periods of time. Several years of treatment to suppress the immune system may be necessary to achieve these results.

• #1 Leading Polymyositis Treatment in Brisbane | ArthritisCARE

  https://arthritiscare.com.au/polymyositis/

  We also recommend non-medical therapies to improve your overall health and help your body fight the disease. Physiotherapy helps improve muscle strength and flexibility. Exercise regularly to improve your health and strengthen your body. Occupational therapy to manage daily activities despite muscle weakness. […] There is no single best treatment for polymyositis, as it depends on the severity of the disease and the patients individual needs. Therapy typically involves a combination of medications, physical therapy, and lifestyle modifications to provide relief, manage inflammation and other signs, and improve your quality of life. […] Although there is no current cure for polymyositis, with early intervention and management, you can achieve remission. People can make a full recovery and return to normal life, such as playing sports; however, they may need to remain on treatments for several years to ensure they are in full remission.

• #1

• #2 Polymyositis: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12053-polymyositis

  Polymyositis is a rare autoimmune disease that makes your immune system attack your muscles. […] Experts arent certain what causes polymyositis, and theres no cure for it. A healthcare provider will treat the symptoms youre experiencing and suggest ways to manage how much they affect your daily routine. […] Theres no cure for polymyositis. Your provider will suggest treatments to manage the inflammation. Treatments cant make the polymyositis go away, but it can reduce how much symptoms affect your day-to-day life. Many people reach a period of remission (when theres no inflammation in your affected muscles). […] The most common treatments for polymyositis include: Corticosteroids: Prescription anti-inflammatory medications. Immunosuppressants: Medications that reduce your immune systems activity and reduce how much it damages your muscles. Intravenous immunoglobulin (IVIG): Extra antibodies your provider will inject into one of your veins. IVIG can redirect your immune system so it cant attack your bodys tissue. IVIG acts like a distraction. If your immune system is focused on going after the IVIG antibodies, it wont damage your muscles as much. Physical therapy: Your provider or a physical therapist will give you stretches and exercises to keep your affected muscles flexible and strong. Physical therapy can strengthen your affected muscles and reduce how much youre affected by future polymyositis episodes.

• #2 Evaluation and Management of Polymyositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3482800/

  Polymyositis (PM) is one of the inflammatory myopathies, disorders characterized pathologically by the presence of inflammatory infiltrates in striated muscle. […] Corticosteroids and immunosuppressive agents are the mainstays of therapy for PM. The principal goals of therapy are to improve strength and improve physical functioning. […] The mainstays of therapy are corticosteroids and other immunosuppressive drugs. Adjunctive, non-pharmacologic therapies are also important. These include exercise regimens appropriate to strength, measures to prevent aspiration, and general supportive care. […] Corticosteroids like prednisone are the first line of therapy for PM. The usual starting dose is 1 mg/kg/day of prednisone or its equivalent. […] After the initial 6-8 weeks, a slow taper of steroids should begin. The goal is to taper steroids off or to the lowest possible effective dose over a period of 9-12 months.

• #2 Polymyositis – Myositis Support and Understanding

  https://understandingmyositis.org/myositis/polymyositis/

  Since steroids, especially in high doses and over prolonged periods, are known to have many adverse side effects and may cause many other health issues, the introduction of steroid-sparing medications should be considered. […] Steroid-sparing agents, such as immunosuppressive drugs and Disease-Modifying Antirheumatic Drugs (DMARDs), have an added benefit as they often reduce or eliminate the need for steroids while also improving the symptoms of polymyositis. […] Some commonly used immunosuppressive drugs include azathioprine (Imuran), mycophenolate mofetil (Cellcept), and Tacrolimus (Prograf). […] Cyclophosphamide (Cytoxan) is one of these medications used. […] Immunoglobulin comes from antibodies extracted from the plasma from thousands of blood donors. […] Acthar Gel, a corticotropin, is delivered either subcutaneously or via intramuscular injection, injected beneath the skin or into the muscle. […] Plasmapheresis (plasma exchange) is a process in which the fluid part of the blood, called plasma, is removed from blood cells by a device known as a cell separator.

• #2 Evaluation and Management of Polymyositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3482800/

  In a steroid responsive patient, the goal is to attain the lowest dose of steroids that will adequately manage the disease. In order to achieve this goal, steroid-sparing agents are necessary in most PM patients. […] Mycophenolate mofetil is administered orally in doses up to 3 g/day. […] Cyclosporine A and tacrolimus have both shown some efficacy in the treatment of refractory PM. […] In patients who are corticosteroid resistant, especially where there is rapidly progressive or life-threatening progression, intravenous immunoglobulin (IVIG) may be helpful. […] Rituximab (RTX) is a monoclonal antibody against CD 20 positive B-cells, which causes depletion of these cells for 6 months or longer. […] Cyclophosphamide (CTX) is an alkylating agent that is toxic to lymphopoietic cells. Both T-cells and antibody producing B-cells are affected. CTX has considerable hematologic and bladder toxicity, and is a potent immunosuppressive.

• #2 Polymyositis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/polymyositis/diagnosis-treatment/drc-20353212

  Although there’s no cure for polymyositis, treatment can improve your muscle strength and function. The earlier treatment is started in the course of polymyositis, the more effective it is leading to fewer complications. […] However, as with many conditions, no single approach is best; your doctor will tailor your treatment strategy based on your symptoms and how well they respond to therapy. […] The most commonly used medications to treat polymyositis include: […] Corticosteroids. Drugs such as prednisone can be very effective in controlling polymyositis symptoms. But prolonged use of these drugs can have serious and wide-ranging side effects, which is why your doctor may gradually taper the dose of medication down to lower levels. […] Corticosteroid-sparing agents. When used in combination with a corticosteroid, these drugs can decrease the dose and potential side effects of the corticosteroid. The two most common medications used for polymyositis are azathioprine (Azasan, Imuran) and methotrexate (Trexall). Other medications prescribed for polymyositis include mycophenolate mofetil (CellCept), cyclosporine and tacrolimus.

• #2 Polymyositis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/polymyositis/diagnosis-treatment/drc-20353212

  Rituximab (Rituxan). More commonly used to treat rheumatoid arthritis, rituximab is an option if initial therapies don’t adequately control your polymyositis symptoms. […] Depending on the severity of your symptoms, your doctor might suggest: […] Physical therapy. A physical therapist can show you exercises to maintain and improve your strength and flexibility and advise an appropriate level of activity. […] Speech therapy. If your swallowing muscles are weakened by polymyositis, speech therapy can help you learn how to compensate for those changes. […] Dietetic assessment. Later in the course of polymyositis, chewing and swallowing can become more difficult. A registered dietitian can teach you how to prepare easy-to-eat, nutritious foods. […] Intravenous immunoglobulin (IVIg) is a purified blood product that contains healthy antibodies from thousands of blood donors. These healthy antibodies can block the damaging antibodies that attack muscle in polymyositis. Given as an infusion through a vein, IVIg treatments may need to be repeated regularly for the effects to continue.

• #2 Polymyositis: Causes, Symptoms, and Treatment

  https://www.webmd.com/arthritis/polymyositis

  Speech therapy. Polymyositis can weaken the muscles you use to speak. A speech therapist can help with your pronunciation so you can speak more clearly. […] Dietetic assessment. Over time, muscle weakness can make it difficult to chew and swallow. A nutritionist or registered dietitian can help you plan soft and nutritious meals. […] Some people with polymyositis benefit from regular blood infusions. During this procedure, a medical professional will use an IV to give you antibodies called immunoglobulins. These healthy antibodies help protect your muscles from autoimmune attacks. […] If you have difficulty moving, braces and other special devices can help. […] Talk to your doctor about the best treatments for you.

• #2 Polymyositis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563129/

  Patients with different systems involved must be evaluated by the concerned specialty eg, a cardiologist for cardiomyopathy, a pulmonologist for ILD, a speech therapist for voice change, etc. Non-pharmacological treatment includes physical therapy of the affected muscles to prevent disuse atrophy. These patients must be advised to have supervised resistive strength training activities. These individuals should be advised to have a diet rich in proteins that help in muscle building.

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