Materiały źródłowe

• #1 Treatment of Myositis – Johns Hopkins Myositis Center

  https://www.hopkinsmyositis.org/unique/treatment-myositis/

  As of now, there is no cure for myositis. However, management of the disease is critical in order to reduce inflammation caused by myositis and to prevent muscle weakness from progressing. Further, your doctor will recommend lifestyle changes so you can restore your strength. […] There are two approaches to treatment for myositis: medical treatment and lifestyle management changes. […] Your doctor will probably recommend a course of medical therapy using the following 2 classes of drugs: Corticosteroids (i.e., prednisone) and other drugs that suppress the immune system (immunosuppresants) may slow down the attack on healthy tissue and improve skin rash. […] You may also want to use nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin or ibuprofen for pain relief. […] After drug treatment takes effect, a program of regular stretching exercises prescribed by your doctor can help maintain range of motion in weakened arms and legs. […] Getting enough rest is an important component of managing myositis. […] What you eat can affect your overall health. […] It is imperative that myositis patients find outlets for the daily stress that most of us have in our lives.

• #2 Myositis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/24170-myositis

  Myositis makes your immune system attack your muscles. […] Theres no cure for myositis, but in most cases, treatment can put it into remission. […] Your healthcare provider will treat the symptoms youre experiencing. Theyll also recommend exercises like stretching and physical movements that can help strengthen your affected muscles between episodes of myositis symptoms. […] The sooner you begin treatment, the more likely it is you can avoid having severe complications. […] Theres no cure for myositis. Your provider will treat your symptoms to reduce their impact on your daily routine. Their goal will be to treat your symptoms until the myositis goes into remission (when theres little or no inflammation in your muscles). Typical treatments for myositis include: Corticosteroids, Immunosuppressants, Intravenous immunoglobulin. […] Even though theres no cure for myositis, your healthcare provider will help you find treatments and physical therapy exercises that will manage your symptoms.

• #2 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  The purpose of this review was to give an update on treatment modalities for patients with idiopathic inflammatory myopathies, or shortly myositis, excluding the subgroup inclusion body myositis, based on a literature survey on therapies used in myositis. […] Glucocorticoid (GC) in high doses is still the first-line treatment of patients with myositis. There is a general recommendation to combine GCs with another immunosuppressive agent in the early phase of disease to better control disease activity and possibly to reduce the risk for GC-related side effects. Furthermore, combining pharmacological treatment with individualized and supervised exercise can be recommended based on evidence. […] Immunosuppressive treatment in combination with exercise is recommended for patients with myositis to reduce disease activity and improve muscle performance. Subgrouping of patients into clinical and serological subtypes may be a way to identify biomarkers for response to specific immunosuppressive and biological agents and should be considered in future trials.

• #3 Myositis Causes, Symptoms, and Treatments | UPMC

  https://www.upmc.com/services/rheumatology/conditions/myositis

  Treatments help to prevent muscle loss and heart, lung, and other problems myositis can cause. […] Doctors treat myositis with medicine, physical therapy (PT), and lifestyle changes. […] Treatment options include: glucocorticoids (such as steroids) to reduce inflammation, immune-suppressing drugs to keep your immune system from attacking healthy tissue, biologic (injectable) drugs to alter certain immune system processes, intravenous immune globulin (IVIG), a blood product to support healthy immune function. […] PT and exercise can prevent muscle loss and help you function in your daily life. […] No, there’s no cure for myositis, but early treatment can prevent further muscle weakness. […] Many people can build back muscle strength through treatments. […] Although myositis is serious, doctors can treat this disease. People with myositis can live full, healthy lives.

• #3 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  Despite the absence of clear data derived from randomized controlled trials, treatment with GCs remains the first therapeutic approach in clinical practice for patients with IIMs. The treatment is able to reduce muscular inflammation, and more than 60% of the patients show improvement of muscle symptoms when treated with GCs. […] In patients with severe disease, such as those with severe muscle impairment, dysphagia, rapidly progressive interstitial lung disease (ILD), or skin ulcers, an induction therapy with intravenous methylprednisolone pulses is often recommended. […] Although GCs are usually effective in the treatment of IIMs, at least to some extent, a great number of patients require the addition of another immunosuppressive drug for refractory disease, disease flares, and skin involvement or to reduce the GC cumulative dose.

• #4 Myositis Treatment | National Jewish Health

  https://www.nationaljewish.org/conditions/myositis/treatment

  Early recognition of the disease is essential. This will allow for early treatment for people with myositis. […] Because it is a chronic disease with no cure, lasting a long time, people often need medical therapy for many years. […] There are many medicine options for people with myositis. Most people require immunosuppressive medicines. This helps control the inflammation and damage caused by the abnormal immune response. Medicines used in myositis include prednisone, hydroxychloroquine, methotrexate, azathioprine, cyclosporine, mycophenolate, mofetil, cyclophosphamide, rituximab, cyclosporine tacrolimus and gamma globulin infusions. […] In addition to medical therapy for myositis, many people require physical therapy, speech therapy and rehabilitation. Under the guidance of rehabilitation therapists, patients learn how to appropriately rest, exercise, and strengthen the various muscle groups affected by myositis.

• #4

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Despite these proposals and several ongoing trials, glucocorticoids (GCs) remain the first-line therapy in treatment of IIM, but the use of immunosuppressive drugs as adjunctive therapy is increasing in the early phases of the disease, both for adjunctive efficacy and for their steroid sparing effect. […] The aim of this review is to provide currently available evidence for GCs and traditional immunotherapy in the treatment of IIM and to provide an overview of the novel therapies available for treatment of refractory patients. […] Despite the absence of clear data derived from randomized controlled trials, treatment with GCs remains the first therapeutic approach in clinical practice for patients with IIMs. […] The treatment is able to reduce muscular inflammation, and more than 60% of the patients show improvement of muscle symptoms when treated with GCs.

• #5 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.

• #6 Corticosteroids – The Myositis Association

  https://www.myositis.org/about-myositis/treatment-disease-management/medications/corticosteroids/

  Corticosteroids are commonly used as first-line treatment with fairly rapid results in dermatomyositis, polymyositis, necrotizing myopathy, and juvenile myositis. Corticosteroids, such as prednisone, slow the bodys immune system and stop the inflammatory attack on muscle, skin, and other body systems. These medicines control the inflammation, ease pain, and increase muscle strength. […] In some cases, patients may not be able to stop taking corticosteroids completely. Many myositis patients must continue to take 5-10 mg of prednisone a day to control their symptoms. This low dose can be maintained indefinitely with few severe side effects. […] Acthar is a synthetic, long-acting form of corticotropin hormone, also known as adrenocorticotropic hormone (ACTH). It is injected either subcutaneously (under the skin) or intramuscularly (into the muscle) to treat polymyositis and dermatomyositis. It is the only drug that is approved by the FDA for treating myositis diseases other than corticosteroids.

• #7

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Despite these proposals and several ongoing trials, glucocorticoids (GCs) remain the first-line therapy in treatment of IIM, but the use of immunosuppressive drugs as adjunctive therapy is increasing in the early phases of the disease, both for adjunctive efficacy and for their steroid sparing effect. […] The aim of this review is to provide currently available evidence for GCs and traditional immunotherapy in the treatment of IIM and to provide an overview of the novel therapies available for treatment of refractory patients. […] Despite the absence of clear data derived from randomized controlled trials, treatment with GCs remains the first therapeutic approach in clinical practice for patients with IIMs. […] The treatment is able to reduce muscular inflammation, and more than 60% of the patients show improvement of muscle symptoms when treated with GCs.

• #8

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  In patients with severe disease, such as those with severe muscle impairment, dysphagia, rapidly progressive interstitial lung disease (ILD), or skin ulcers, an induction therapy with intravenous methylprednisolone pulses (500-1000 mg/day for three consecutive days) is often recommended. […] Although GCs are usually effective in the treatment of IIMs, at least to some extent, a great number of patients require the addition of another immunosuppressive drug for refractory disease, disease flares, and skin involvement or to reduce the GC cumulative dose. […] The effects of adrenocorticotropic hormone gel (ACTH gel) were studied in a retrospective case series and in a recent open-label trial. […] As reported in observational studies, treatment of skin involvement in DM with antimalarials (hydroxychloroquine (HCQ) or quinacrine) in combination with GCs with or without immunosuppressors is effective in 40-75% of the patients.

• #9 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.

• #10 Myositis | Causes, symptoms, treatment

  https://versusarthritis.org/about-arthritis/conditions/myositis/

• #11 Corticosteroids – The Myositis Association

  https://www.myositis.org/about-myositis/treatment-disease-management/medications/corticosteroids/

  Corticosteroids are commonly used as first-line treatment with fairly rapid results in dermatomyositis, polymyositis, necrotizing myopathy, and juvenile myositis. Corticosteroids, such as prednisone, slow the bodys immune system and stop the inflammatory attack on muscle, skin, and other body systems. These medicines control the inflammation, ease pain, and increase muscle strength. […] In some cases, patients may not be able to stop taking corticosteroids completely. Many myositis patients must continue to take 5-10 mg of prednisone a day to control their symptoms. This low dose can be maintained indefinitely with few severe side effects. […] Acthar is a synthetic, long-acting form of corticotropin hormone, also known as adrenocorticotropic hormone (ACTH). It is injected either subcutaneously (under the skin) or intramuscularly (into the muscle) to treat polymyositis and dermatomyositis. It is the only drug that is approved by the FDA for treating myositis diseases other than corticosteroids.

• #12 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.

• #13 Myositis | Causes, symptoms, treatment

  https://versusarthritis.org/about-arthritis/conditions/myositis/

• #14 Myositis | Causes, symptoms, treatment

  https://versusarthritis.org/about-arthritis/conditions/myositis/

• #15 Corticosteroids – The Myositis Association

  https://www.myositis.org/about-myositis/treatment-disease-management/medications/corticosteroids/

  Corticosteroids are commonly used as first-line treatment with fairly rapid results in dermatomyositis, polymyositis, necrotizing myopathy, and juvenile myositis. Corticosteroids, such as prednisone, slow the bodys immune system and stop the inflammatory attack on muscle, skin, and other body systems. These medicines control the inflammation, ease pain, and increase muscle strength. […] In some cases, patients may not be able to stop taking corticosteroids completely. Many myositis patients must continue to take 5-10 mg of prednisone a day to control their symptoms. This low dose can be maintained indefinitely with few severe side effects. […] Acthar is a synthetic, long-acting form of corticotropin hormone, also known as adrenocorticotropic hormone (ACTH). It is injected either subcutaneously (under the skin) or intramuscularly (into the muscle) to treat polymyositis and dermatomyositis. It is the only drug that is approved by the FDA for treating myositis diseases other than corticosteroids.

• #16 Myositis Treatments – Myositis Support and Understanding

  https://understandingmyositis.org/myositis-treatments/

  Acthar Gel is the only FDA approved drug for polymyositis and dermatomyositis other than corticosteroids like prednisone. […] IVIG is also being increasingly used in PM and DM when other drugs fail or are poorly tolerated. […] Plasmapheresis (also referred to as 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. […] While medications play an important role in treating and managing most forms of myositis, there are also other forms of therapy that must be included. […] Exercise is a large focus now since research debunked the old myth that myositis patients should not exercise. […] The side effects of treatments used for Myositis can range from minimal to extreme. Corticosteroids are considered the first line of treatment because they are inexpensive and fast acting, however long-term, high-dose use can bring on an array of side effects ranging from annoying to life threatening. […] Other treatments for Myositis, typically those which suppress the immune system and are used as chemotherapy or organ rejection drugs, can have equally serious side effects.

• #17 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  The purpose of this review was to give an update on treatment modalities for patients with idiopathic inflammatory myopathies, or shortly myositis, excluding the subgroup inclusion body myositis, based on a literature survey on therapies used in myositis. […] Glucocorticoid (GC) in high doses is still the first-line treatment of patients with myositis. There is a general recommendation to combine GCs with another immunosuppressive agent in the early phase of disease to better control disease activity and possibly to reduce the risk for GC-related side effects. Furthermore, combining pharmacological treatment with individualized and supervised exercise can be recommended based on evidence. […] Immunosuppressive treatment in combination with exercise is recommended for patients with myositis to reduce disease activity and improve muscle performance. Subgrouping of patients into clinical and serological subtypes may be a way to identify biomarkers for response to specific immunosuppressive and biological agents and should be considered in future trials.

• #18 Myositis | Diagnosis & Disease Information

  https://www.rheumatologyadvisor.com/ddi/myositis/

  Disease-modifying antirheumatic drugs (DMARDs), including methotrexate, azathioprine, tacrolimus, ciclosporin, and mycophenolate mofetil, are used to reduce active muscle inflammation and steroid burden, as well as to achieve clinical remission. […] If the disease is severe or refractory to glucocorticoids and DMARDs, the following second-line treatment options should be considered, in this order: intravenous immunoglobulin; rituximab (particularly effective in JM, positive autoantibody, and lower burden disease); cyclophosphamide; and abatacept (adults only). […] According to the BSR guidelines, all patients with myositis should engage in exercise programs developed by a specialized physiotherapist or occupational therapist to improve quality of life and muscle function. […] Monitoring these adverse effects and adjusting the dose is an important component of myositis treatment.

• #19

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Despite these proposals and several ongoing trials, glucocorticoids (GCs) remain the first-line therapy in treatment of IIM, but the use of immunosuppressive drugs as adjunctive therapy is increasing in the early phases of the disease, both for adjunctive efficacy and for their steroid sparing effect. […] The aim of this review is to provide currently available evidence for GCs and traditional immunotherapy in the treatment of IIM and to provide an overview of the novel therapies available for treatment of refractory patients. […] Despite the absence of clear data derived from randomized controlled trials, treatment with GCs remains the first therapeutic approach in clinical practice for patients with IIMs. […] The treatment is able to reduce muscular inflammation, and more than 60% of the patients show improvement of muscle symptoms when treated with GCs.

• #20 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  The aim of this review is to provide currently available evidence for GCs and traditional immunotherapy in the treatment of IIM and to provide an overview of the novel therapies available for treatment of refractory patients. […] The effects of adrenocorticotropic hormone gel (ACTH gel) were studied in a retrospective case series and in a recent open-label trial. […] As reported in observational studies, treatment of skin involvement in DM with antimalarials (hydroxychloroquine (HCQ) or quinacrine) in combination with GCs with or without immunosuppressors is effective in 40-75% of the patients. […] Methotrexate (MTX), together with azathioprine, is considered as the first choice of immunotherapeutic agents to treat the muscular involvement in IIM. […] Azathioprine (AZA) is a purine analogue and acts as antimetabolite, blocking the purine and metabolism and the RNA and DNA synthesis.

• #21

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Methotrexate (MTX), together with azathioprine, is considered as the first choice of immunotherapeutic agents to treat the muscular involvement in IIM. […] Azathioprine (AZA) is a purine analogue and acts as antimetabolite, blocking the purine and metabolism and the RNA and DNA synthesis. […] Cyclosporine-A (CYA) and tacrolimus (TAC) are calcineurin inhibitors (CNIs) and their main effects are the inhibition of T cell activation and reduction of the activity of genes coding for IL-2 and related cytokines. […] Mycophenolate mofetil (MMF) is a prodrug that inhibits T and B cell proliferation reducing the guanosine nucleotide synthesis. […] Intravenous immunoglobulins (IVIG) are preparations produced from pooled IgG preparations from thousands of donors and contain antibodies directed against a broad range of pathogens, as well as against numerous foreign and self-antigens.

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

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

  Myositis is an autoimmune disease characterized by inflammation of muscle. […] 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. […] 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. […] The medicines used to treat myositis most often work by blocking or suppressing the white blood cells of the immune system, since these are causing the underlying damage to muscle tissue.

• #23 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  The aim of this review is to provide currently available evidence for GCs and traditional immunotherapy in the treatment of IIM and to provide an overview of the novel therapies available for treatment of refractory patients. […] The effects of adrenocorticotropic hormone gel (ACTH gel) were studied in a retrospective case series and in a recent open-label trial. […] As reported in observational studies, treatment of skin involvement in DM with antimalarials (hydroxychloroquine (HCQ) or quinacrine) in combination with GCs with or without immunosuppressors is effective in 40-75% of the patients. […] Methotrexate (MTX), together with azathioprine, is considered as the first choice of immunotherapeutic agents to treat the muscular involvement in IIM. […] Azathioprine (AZA) is a purine analogue and acts as antimetabolite, blocking the purine and metabolism and the RNA and DNA synthesis.

• #24

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Methotrexate (MTX), together with azathioprine, is considered as the first choice of immunotherapeutic agents to treat the muscular involvement in IIM. […] Azathioprine (AZA) is a purine analogue and acts as antimetabolite, blocking the purine and metabolism and the RNA and DNA synthesis. […] Cyclosporine-A (CYA) and tacrolimus (TAC) are calcineurin inhibitors (CNIs) and their main effects are the inhibition of T cell activation and reduction of the activity of genes coding for IL-2 and related cytokines. […] Mycophenolate mofetil (MMF) is a prodrug that inhibits T and B cell proliferation reducing the guanosine nucleotide synthesis. […] Intravenous immunoglobulins (IVIG) are preparations produced from pooled IgG preparations from thousands of donors and contain antibodies directed against a broad range of pathogens, as well as against numerous foreign and self-antigens.

• #25 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  The aim of this review is to provide currently available evidence for GCs and traditional immunotherapy in the treatment of IIM and to provide an overview of the novel therapies available for treatment of refractory patients. […] The effects of adrenocorticotropic hormone gel (ACTH gel) were studied in a retrospective case series and in a recent open-label trial. […] As reported in observational studies, treatment of skin involvement in DM with antimalarials (hydroxychloroquine (HCQ) or quinacrine) in combination with GCs with or without immunosuppressors is effective in 40-75% of the patients. […] Methotrexate (MTX), together with azathioprine, is considered as the first choice of immunotherapeutic agents to treat the muscular involvement in IIM. […] Azathioprine (AZA) is a purine analogue and acts as antimetabolite, blocking the purine and metabolism and the RNA and DNA synthesis.

• #26

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Methotrexate (MTX), together with azathioprine, is considered as the first choice of immunotherapeutic agents to treat the muscular involvement in IIM. […] Azathioprine (AZA) is a purine analogue and acts as antimetabolite, blocking the purine and metabolism and the RNA and DNA synthesis. […] Cyclosporine-A (CYA) and tacrolimus (TAC) are calcineurin inhibitors (CNIs) and their main effects are the inhibition of T cell activation and reduction of the activity of genes coding for IL-2 and related cytokines. […] Mycophenolate mofetil (MMF) is a prodrug that inhibits T and B cell proliferation reducing the guanosine nucleotide synthesis. […] Intravenous immunoglobulins (IVIG) are preparations produced from pooled IgG preparations from thousands of donors and contain antibodies directed against a broad range of pathogens, as well as against numerous foreign and self-antigens.

• #27 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  Cyclosporine-A (CYA) and tacrolimus (TAC) are calcineurin inhibitors (CNIs) and their main effects are the inhibition of T cell activation and reduction of the activity of genes coding for IL-2 and related cytokines. […] Mycophenolate mofetil (MMF) is a prodrug that inhibits T and B cell proliferation reducing the guanosine nucleotide synthesis. […] Intravenous immunoglobulins (IVIG) are preparations produced from pooled IgG preparations from thousands of donors and contain antibodies directed against a broad range of pathogens, as well as against numerous foreign and self-antigens. […] Rituximab (RTX) is a chimeric monoclonal antibody against the protein CD20, primarily expressed on the surface of the B cells. […] In the last years, different biotechnological drugs have been tested in the treatment of IIM but the number of patients treated is scarce and their use can be suggested only whenever other treatments are ineffective.

• #28

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Methotrexate (MTX), together with azathioprine, is considered as the first choice of immunotherapeutic agents to treat the muscular involvement in IIM. […] Azathioprine (AZA) is a purine analogue and acts as antimetabolite, blocking the purine and metabolism and the RNA and DNA synthesis. […] Cyclosporine-A (CYA) and tacrolimus (TAC) are calcineurin inhibitors (CNIs) and their main effects are the inhibition of T cell activation and reduction of the activity of genes coding for IL-2 and related cytokines. […] Mycophenolate mofetil (MMF) is a prodrug that inhibits T and B cell proliferation reducing the guanosine nucleotide synthesis. […] Intravenous immunoglobulins (IVIG) are preparations produced from pooled IgG preparations from thousands of donors and contain antibodies directed against a broad range of pathogens, as well as against numerous foreign and self-antigens.

• #29 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  Cyclosporine-A (CYA) and tacrolimus (TAC) are calcineurin inhibitors (CNIs) and their main effects are the inhibition of T cell activation and reduction of the activity of genes coding for IL-2 and related cytokines. […] Mycophenolate mofetil (MMF) is a prodrug that inhibits T and B cell proliferation reducing the guanosine nucleotide synthesis. […] Intravenous immunoglobulins (IVIG) are preparations produced from pooled IgG preparations from thousands of donors and contain antibodies directed against a broad range of pathogens, as well as against numerous foreign and self-antigens. […] Rituximab (RTX) is a chimeric monoclonal antibody against the protein CD20, primarily expressed on the surface of the B cells. […] In the last years, different biotechnological drugs have been tested in the treatment of IIM but the number of patients treated is scarce and their use can be suggested only whenever other treatments are ineffective.

• #30

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Methotrexate (MTX), together with azathioprine, is considered as the first choice of immunotherapeutic agents to treat the muscular involvement in IIM. […] Azathioprine (AZA) is a purine analogue and acts as antimetabolite, blocking the purine and metabolism and the RNA and DNA synthesis. […] Cyclosporine-A (CYA) and tacrolimus (TAC) are calcineurin inhibitors (CNIs) and their main effects are the inhibition of T cell activation and reduction of the activity of genes coding for IL-2 and related cytokines. […] Mycophenolate mofetil (MMF) is a prodrug that inhibits T and B cell proliferation reducing the guanosine nucleotide synthesis. […] Intravenous immunoglobulins (IVIG) are preparations produced from pooled IgG preparations from thousands of donors and contain antibodies directed against a broad range of pathogens, as well as against numerous foreign and self-antigens.

• #31 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  The aim of this review is to provide currently available evidence for GCs and traditional immunotherapy in the treatment of IIM and to provide an overview of the novel therapies available for treatment of refractory patients. […] The effects of adrenocorticotropic hormone gel (ACTH gel) were studied in a retrospective case series and in a recent open-label trial. […] As reported in observational studies, treatment of skin involvement in DM with antimalarials (hydroxychloroquine (HCQ) or quinacrine) in combination with GCs with or without immunosuppressors is effective in 40-75% of the patients. […] Methotrexate (MTX), together with azathioprine, is considered as the first choice of immunotherapeutic agents to treat the muscular involvement in IIM. […] Azathioprine (AZA) is a purine analogue and acts as antimetabolite, blocking the purine and metabolism and the RNA and DNA synthesis.

• #32

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  In patients with severe disease, such as those with severe muscle impairment, dysphagia, rapidly progressive interstitial lung disease (ILD), or skin ulcers, an induction therapy with intravenous methylprednisolone pulses (500-1000 mg/day for three consecutive days) is often recommended. […] Although GCs are usually effective in the treatment of IIMs, at least to some extent, a great number of patients require the addition of another immunosuppressive drug for refractory disease, disease flares, and skin involvement or to reduce the GC cumulative dose. […] The effects of adrenocorticotropic hormone gel (ACTH gel) were studied in a retrospective case series and in a recent open-label trial. […] As reported in observational studies, treatment of skin involvement in DM with antimalarials (hydroxychloroquine (HCQ) or quinacrine) in combination with GCs with or without immunosuppressors is effective in 40-75% of the patients.

• #33 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  Cyclosporine-A (CYA) and tacrolimus (TAC) are calcineurin inhibitors (CNIs) and their main effects are the inhibition of T cell activation and reduction of the activity of genes coding for IL-2 and related cytokines. […] Mycophenolate mofetil (MMF) is a prodrug that inhibits T and B cell proliferation reducing the guanosine nucleotide synthesis. […] Intravenous immunoglobulins (IVIG) are preparations produced from pooled IgG preparations from thousands of donors and contain antibodies directed against a broad range of pathogens, as well as against numerous foreign and self-antigens. […] Rituximab (RTX) is a chimeric monoclonal antibody against the protein CD20, primarily expressed on the surface of the B cells. […] In the last years, different biotechnological drugs have been tested in the treatment of IIM but the number of patients treated is scarce and their use can be suggested only whenever other treatments are ineffective.

• #34

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Rituximab (RTX) is a chimeric monoclonal antibody against the protein CD20, primarily expressed on the surface of the B cells. […] In the last years, different biotechnological drugs have been tested in the treatment of IIM but the number of patients treated is scarce and their use can be suggested only whenever other treatments are ineffective. […] During the last years, exercise has been identified as an important adjunct part of the treatment for patients with IIM. Exercise may improve muscular metabolism, physical capacity, autonomy, and quality of life in patients with IIM. […] Based on accumulated data on the beneficial effect of exercise in patients with PM and DM, all patients with IIM can be recommended to start physical training as soon as possible after start of immunosuppressive treatment.

• #35 Myositis | Causes, symptoms, treatment

  https://versusarthritis.org/about-arthritis/conditions/myositis/

• #36 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  Cyclosporine-A (CYA) and tacrolimus (TAC) are calcineurin inhibitors (CNIs) and their main effects are the inhibition of T cell activation and reduction of the activity of genes coding for IL-2 and related cytokines. […] Mycophenolate mofetil (MMF) is a prodrug that inhibits T and B cell proliferation reducing the guanosine nucleotide synthesis. […] Intravenous immunoglobulins (IVIG) are preparations produced from pooled IgG preparations from thousands of donors and contain antibodies directed against a broad range of pathogens, as well as against numerous foreign and self-antigens. […] Rituximab (RTX) is a chimeric monoclonal antibody against the protein CD20, primarily expressed on the surface of the B cells. […] In the last years, different biotechnological drugs have been tested in the treatment of IIM but the number of patients treated is scarce and their use can be suggested only whenever other treatments are ineffective.

• #37

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Methotrexate (MTX), together with azathioprine, is considered as the first choice of immunotherapeutic agents to treat the muscular involvement in IIM. […] Azathioprine (AZA) is a purine analogue and acts as antimetabolite, blocking the purine and metabolism and the RNA and DNA synthesis. […] Cyclosporine-A (CYA) and tacrolimus (TAC) are calcineurin inhibitors (CNIs) and their main effects are the inhibition of T cell activation and reduction of the activity of genes coding for IL-2 and related cytokines. […] Mycophenolate mofetil (MMF) is a prodrug that inhibits T and B cell proliferation reducing the guanosine nucleotide synthesis. […] Intravenous immunoglobulins (IVIG) are preparations produced from pooled IgG preparations from thousands of donors and contain antibodies directed against a broad range of pathogens, as well as against numerous foreign and self-antigens.

• #38 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  Cyclosporine-A (CYA) and tacrolimus (TAC) are calcineurin inhibitors (CNIs) and their main effects are the inhibition of T cell activation and reduction of the activity of genes coding for IL-2 and related cytokines. […] Mycophenolate mofetil (MMF) is a prodrug that inhibits T and B cell proliferation reducing the guanosine nucleotide synthesis. […] Intravenous immunoglobulins (IVIG) are preparations produced from pooled IgG preparations from thousands of donors and contain antibodies directed against a broad range of pathogens, as well as against numerous foreign and self-antigens. […] Rituximab (RTX) is a chimeric monoclonal antibody against the protein CD20, primarily expressed on the surface of the B cells. […] In the last years, different biotechnological drugs have been tested in the treatment of IIM but the number of patients treated is scarce and their use can be suggested only whenever other treatments are ineffective.

• #39

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Rituximab (RTX) is a chimeric monoclonal antibody against the protein CD20, primarily expressed on the surface of the B cells. […] In the last years, different biotechnological drugs have been tested in the treatment of IIM but the number of patients treated is scarce and their use can be suggested only whenever other treatments are ineffective. […] During the last years, exercise has been identified as an important adjunct part of the treatment for patients with IIM. Exercise may improve muscular metabolism, physical capacity, autonomy, and quality of life in patients with IIM. […] Based on accumulated data on the beneficial effect of exercise in patients with PM and DM, all patients with IIM can be recommended to start physical training as soon as possible after start of immunosuppressive treatment.

• #40 Myositis | Diagnosis & Disease Information

  https://www.rheumatologyadvisor.com/ddi/myositis/

  Disease-modifying antirheumatic drugs (DMARDs), including methotrexate, azathioprine, tacrolimus, ciclosporin, and mycophenolate mofetil, are used to reduce active muscle inflammation and steroid burden, as well as to achieve clinical remission. […] If the disease is severe or refractory to glucocorticoids and DMARDs, the following second-line treatment options should be considered, in this order: intravenous immunoglobulin; rituximab (particularly effective in JM, positive autoantibody, and lower burden disease); cyclophosphamide; and abatacept (adults only). […] According to the BSR guidelines, all patients with myositis should engage in exercise programs developed by a specialized physiotherapist or occupational therapist to improve quality of life and muscle function. […] Monitoring these adverse effects and adjusting the dose is an important component of myositis treatment.

• #41 Inflammatory Myopathies

  https://practicalneurology.com/diseases-diagnoses/ms-immune-disorders/inflammatory-myopathies/31812/

  Abatacept is a T-lymphocyte activation inhibitor that has decreased disease activity in nearly half of participants in a clinical trial with DM (n=9) or PM (n=11) refractory to treatment. Another group of 12 individuals with refractory IM (11 PM, 1 DM) who received infliximab 5 or 7.5 mg/kg had dose-dependent clinical improvement defined as more than a 15% manual muscle strength (MMT) improvement at week 16. Pharmacotherapy of the IIMs is summarized in Table e5.

• #42 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  Cyclosporine-A (CYA) and tacrolimus (TAC) are calcineurin inhibitors (CNIs) and their main effects are the inhibition of T cell activation and reduction of the activity of genes coding for IL-2 and related cytokines. […] Mycophenolate mofetil (MMF) is a prodrug that inhibits T and B cell proliferation reducing the guanosine nucleotide synthesis. […] Intravenous immunoglobulins (IVIG) are preparations produced from pooled IgG preparations from thousands of donors and contain antibodies directed against a broad range of pathogens, as well as against numerous foreign and self-antigens. […] Rituximab (RTX) is a chimeric monoclonal antibody against the protein CD20, primarily expressed on the surface of the B cells. […] In the last years, different biotechnological drugs have been tested in the treatment of IIM but the number of patients treated is scarce and their use can be suggested only whenever other treatments are ineffective.

• #43

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Rituximab (RTX) is a chimeric monoclonal antibody against the protein CD20, primarily expressed on the surface of the B cells. […] In the last years, different biotechnological drugs have been tested in the treatment of IIM but the number of patients treated is scarce and their use can be suggested only whenever other treatments are ineffective. […] During the last years, exercise has been identified as an important adjunct part of the treatment for patients with IIM. Exercise may improve muscular metabolism, physical capacity, autonomy, and quality of life in patients with IIM. […] Based on accumulated data on the beneficial effect of exercise in patients with PM and DM, all patients with IIM can be recommended to start physical training as soon as possible after start of immunosuppressive treatment.

• #44 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  During the last years, exercise has been identified as an important adjunct part of the treatment for patients with IIM. Exercise may improve muscular metabolism, physical capacity, autonomy, and quality of life in patients with IIM. […] A main issue in treating patients with IIM is that, due the rarity and heterogeneity of the disease, randomized controlled trials are scarce and evidence-based guidelines/recommendations are lacking. Based on available data, systemic GCs are still the first-line therapy in these patients, and immunosuppressants should be considered to be added from the first phases of the disease in order to better control the disease activity and possibly to reduce the risk for GC-related AE.

• #45

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Rituximab (RTX) is a chimeric monoclonal antibody against the protein CD20, primarily expressed on the surface of the B cells. […] In the last years, different biotechnological drugs have been tested in the treatment of IIM but the number of patients treated is scarce and their use can be suggested only whenever other treatments are ineffective. […] During the last years, exercise has been identified as an important adjunct part of the treatment for patients with IIM. Exercise may improve muscular metabolism, physical capacity, autonomy, and quality of life in patients with IIM. […] Based on accumulated data on the beneficial effect of exercise in patients with PM and DM, all patients with IIM can be recommended to start physical training as soon as possible after start of immunosuppressive treatment.

• #46 Myositis Treatments – Myositis Support and Understanding

  https://understandingmyositis.org/myositis-treatments/

  Acthar Gel is the only FDA approved drug for polymyositis and dermatomyositis other than corticosteroids like prednisone. […] IVIG is also being increasingly used in PM and DM when other drugs fail or are poorly tolerated. […] Plasmapheresis (also referred to as 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. […] While medications play an important role in treating and managing most forms of myositis, there are also other forms of therapy that must be included. […] Exercise is a large focus now since research debunked the old myth that myositis patients should not exercise. […] The side effects of treatments used for Myositis can range from minimal to extreme. Corticosteroids are considered the first line of treatment because they are inexpensive and fast acting, however long-term, high-dose use can bring on an array of side effects ranging from annoying to life threatening. […] Other treatments for Myositis, typically those which suppress the immune system and are used as chemotherapy or organ rejection drugs, can have equally serious side effects.

• #47 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  During the last years, exercise has been identified as an important adjunct part of the treatment for patients with IIM. Exercise may improve muscular metabolism, physical capacity, autonomy, and quality of life in patients with IIM. […] A main issue in treating patients with IIM is that, due the rarity and heterogeneity of the disease, randomized controlled trials are scarce and evidence-based guidelines/recommendations are lacking. Based on available data, systemic GCs are still the first-line therapy in these patients, and immunosuppressants should be considered to be added from the first phases of the disease in order to better control the disease activity and possibly to reduce the risk for GC-related AE.

• #48

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Rituximab (RTX) is a chimeric monoclonal antibody against the protein CD20, primarily expressed on the surface of the B cells. […] In the last years, different biotechnological drugs have been tested in the treatment of IIM but the number of patients treated is scarce and their use can be suggested only whenever other treatments are ineffective. […] During the last years, exercise has been identified as an important adjunct part of the treatment for patients with IIM. Exercise may improve muscular metabolism, physical capacity, autonomy, and quality of life in patients with IIM. […] Based on accumulated data on the beneficial effect of exercise in patients with PM and DM, all patients with IIM can be recommended to start physical training as soon as possible after start of immunosuppressive treatment.

• #49 Exercise and Physical Therapy – The Myositis Association

  https://www.myositis.org/about-myositis/treatment-disease-management/exercise-physical-therapy/

  Exercise and physical therapy are important parts of standard myositis treatment plans. Physical exercise has been shown to reduce inflammation, reduce fatigue, increase stamina, and build muscle, even in patients with myositis. Indeed, exercise is currently the only treatment recommendation for patients with inclusion body myositis. […] Exercise keeps weak muscles from atrophying and helps the body compensate for weakness by strengthening the surrounding musculature. […] It is important to do something rather than nothing at all.

• #50 Treatment in myositis | Nature Reviews Rheumatology

  https://www.nature.com/articles/nrrheum.2018.42

  Managing myositis and its systemic complications represents a challenge to the clinicians providing care as patients often have severe muscle weakness, notable skin rashes and life-threatening organ involvement. […] Conventional therapies include glucocorticoids usually in combination with another or multiple immunosuppressive agents, but biologic therapies targeting immunopathogenic pathways are being increasingly utilized. […] Exercise, once considered controversial in the management of myositis, has emerged as an important adjunct in treating patients with myositis; molecular evidence suggests that exercise regimens are both safe and anti-inflammatory. […] Nevertheless, a multitude of immunosuppressive and immunomodulatory agents are available to clinicians managing myositis, and the emergence of biologic agents targeting potential pathogenic pathways offers hope for mitigating or curing this enigmatic group of diseases. […] Paradigm shifts in the nonpharmacological approach to treat myositis have also occurred as more aggressive exercise regimens have shown benefit in patients, even those with active disease.

• #51 Myositis | Causes, symptoms, treatment

  https://versusarthritis.org/about-arthritis/conditions/myositis/

• #52 Exercise and Physical Therapy – The Myositis Association

  https://www.myositis.org/about-myositis/treatment-disease-management/exercise-physical-therapy/

  Exercise and physical therapy are important parts of standard myositis treatment plans. Physical exercise has been shown to reduce inflammation, reduce fatigue, increase stamina, and build muscle, even in patients with myositis. Indeed, exercise is currently the only treatment recommendation for patients with inclusion body myositis. […] Exercise keeps weak muscles from atrophying and helps the body compensate for weakness by strengthening the surrounding musculature. […] It is important to do something rather than nothing at all.

• #53 Exercise & Rehabilitation Guidelines for Myositis Patients

  https://www.hss.edu/conditions_exercise-physical-therapy-guidelines-myositis.asp

  While exercise will not „cure” myositis, it may help mediate certain aspects of the disease. Exercise can increase muscle strength, flexibility, and cardiovascular status, as well as improve your psychological well being. […] Clinical research on exercise and myositis has been extremely limited. […] However, a recent article in the British journal Rheumatology reported that there were no detrimental effects for 10 people with myositis who participated in an exercise study. […] Exercise only after getting your physician’s approval. […] Because what is best for someone else with myositis may be inappropriate for you, an individualized program is ideal. Consider asking your doctor for referral to a physical therapist who can design the best program for you. […] Physical therapists bring extensive knowledge of the musculoskeletal system to an exercise plan.

• #54 Exercise & Rehabilitation Guidelines for Myositis Patients

  https://www.hss.edu/conditions_exercise-physical-therapy-guidelines-myositis.asp

  If possible, find a friend who will exercise with you. […] Start gradually. Don’t jump into a full-fledged program – this is something you will work up to. […] Always begin your workout with stretching exercises. […] Range of motion exercises can be a focus of an exercise routine. […] There are many ways to modify your exercise program. […] Rest is very important. It allows your muscles to recover. […] Most important, be careful, be safe, have fun, and keep a positive attitude!

• #55

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  Rituximab (RTX) is a chimeric monoclonal antibody against the protein CD20, primarily expressed on the surface of the B cells. […] In the last years, different biotechnological drugs have been tested in the treatment of IIM but the number of patients treated is scarce and their use can be suggested only whenever other treatments are ineffective. […] During the last years, exercise has been identified as an important adjunct part of the treatment for patients with IIM. Exercise may improve muscular metabolism, physical capacity, autonomy, and quality of life in patients with IIM. […] Based on accumulated data on the beneficial effect of exercise in patients with PM and DM, all patients with IIM can be recommended to start physical training as soon as possible after start of immunosuppressive treatment.

• #56 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.

• #57 Exercise & Rehabilitation Guidelines for Myositis Patients

  https://www.hss.edu/conditions_exercise-physical-therapy-guidelines-myositis.asp

  If possible, find a friend who will exercise with you. […] Start gradually. Don’t jump into a full-fledged program – this is something you will work up to. […] Always begin your workout with stretching exercises. […] Range of motion exercises can be a focus of an exercise routine. […] There are many ways to modify your exercise program. […] Rest is very important. It allows your muscles to recover. […] Most important, be careful, be safe, have fun, and keep a positive attitude!

• #58 Myositis treatment – Myositis UK

  https://www.myositis.org.uk/myositis-info/treatments-and-therapies/

  In most cases of myositis, symptoms can be eased with a combination of treatment and therapies. […] Myositis varies from person to person meaning some trial and error may be needed to settle on the best treatment plan. This may involve a combination of medication, exercise, diet and other therapies. […] Polymyositis, dermatomyositis and juvenile dermatomyositis usually respond well to a combination of steroids and immunosuppressive medication such as disease-modifying anti-rheumatic drugs (DMARDs). Regrettably there is no proven treatment for inclusion body myositis but other options are available. […] Active exercise can help to improve and restore muscle strength and is an important part of the treatment plan for people with myositis. […] Other therapies such as speech therapy and mind and body practices can complement treatment plans for those with myositis.

• #59 Myositis Treatments – Myositis Support and Understanding

  https://understandingmyositis.org/myositis-treatments/

  Myositis is an incurable rare disease. There are no FDA-approved treatments or therapies for any type of the idiopathic inflammatory myopathies (IIM), referred to as myositis. However, the use of off-label medications can be successful for many patients to control symptoms and even induce remission. […] There is some encouraging news about treatments for sporadic inclusion body myositis (sIBM) undergoing clinical trials, however, no approved effective treatment currently exists. […] The first line treatment for polymyositis (PM) and dermatomyositis (DM), and for most types of autoimmune myositis with the exception of sporadic inclusion body myositis, is typically corticosteroids to address the inflammation causing the weakness and simultaneously 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 in treating the inflammation.

• #60 Myositis treatment – Myositis UK

  https://www.myositis.org.uk/myositis-info/treatments-and-therapies/

  In most cases of myositis, symptoms can be eased with a combination of treatment and therapies. […] Myositis varies from person to person meaning some trial and error may be needed to settle on the best treatment plan. This may involve a combination of medication, exercise, diet and other therapies. […] Polymyositis, dermatomyositis and juvenile dermatomyositis usually respond well to a combination of steroids and immunosuppressive medication such as disease-modifying anti-rheumatic drugs (DMARDs). Regrettably there is no proven treatment for inclusion body myositis but other options are available. […] Active exercise can help to improve and restore muscle strength and is an important part of the treatment plan for people with myositis. […] Other therapies such as speech therapy and mind and body practices can complement treatment plans for those with myositis.

• #61 Medication – Myositis UK

  https://www.myositis.org.uk/myositis-info/treatments-and-therapies/medication/

  In most cases of myositis, different types of medication are available to help ease symptoms. […] Polymyositis (PM) and dermatomyositis (DM) are treated in the same way. Once the disease has been diagnosed, most respond well to steroids. […] Gradually the steroid dosage is lowered. […] To help reduce the inflammation, immunosuppressive medication may be prescribed such as a disease-modifying anti-rheumatic drug (DMARDs). […] If your condition does not improve, you may be treated with biological therapies like infliximab and rituximab or other medications such as cyclophosphamide. […] If steroids arent improving your condition, this might be a sign you have inclusion body myositis (IBM) instead of PM or DM as IBM does not respond to steroids. […] In the case of juvenile dermatomyositis (JDM), the treatment is the same as that for PM and DM, except dosages tend to be calculated based on body weight.

• #62 Myositis Treatment – CreakyJoints Australia

  https://creakyjoints.org.au/education/myositis/treatment/

  Myositis treatment varies according to the cause. Typically myositis treatment is a combination of medication, rest, and exercise or physical therapy in the recovery phase. If inflammatory conditions such as lupus are the cause, treatment of the underlying disease may be helpful; if not, corticosteroid drugs that suppress the immune system are used. For polymyositis and dermatomyositis, doctors usually begin treatment with a corticosteroid drug. If this fails, disease-modifying anti-rheumatic drugs (DMARDs) are used. In patients for whom none of these treatments work, immunoglobulin injections from blood donors are an option. There is no effective treatment for inclusion body myositis, although corticosteroid treatment and immune-suppressing therapies are helpful in some people. […] Corticosteroids that suppress the immune system such as prednisone, azathioprine and methotrexate are commonly used to treat myositis as a way to slow the immune systems attack on healthy tissues. Over the counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin may help relieve pain. For polymyositis and dermatomyositis, doctors usually begin treatment with a corticosteroid drug, such as prednisone. If this fails, methotrexate (commonly used to treat some forms of arthritis) or azathioprine may be added. In patients for whom none of these treatments work, immunoglobulin injections from blood donors are used. There is no effective treatment for inclusion body myositis, although corticosteroid treatment and immunosuppressive therapies are helpful in some people.

• #63 Dermatomyositis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dermatomyositis/diagnosis-treatment/drc-20353192

  Rituximab (Rituxan). More commonly used to treat rheumatoid arthritis, rituximab is an option if initial therapies don’t control your symptoms. […] Antimalarial medications. For a persistent rash, your doctor might prescribe an antimalarial medication, such as hydroxychloroquine (Plaquenil). […] Sunscreens. Protecting your skin from sun exposure by applying sunscreen and wearing protective clothing and hats is important for managing the rash of dermatomyositis. […] Depending on the severity of your symptoms, your doctor might suggest: […] Physical therapy. A physical therapist can show you exercises to help maintain and improve your strength and flexibility and advise you about an appropriate level of activity. […] Speech therapy. If your swallowing muscles are affected, speech therapy can help you learn how to compensate for those changes.

• #64 Medication – Myositis UK

  https://www.myositis.org.uk/myositis-info/treatments-and-therapies/medication/

  In order to minimise side effects related to steroids, children will also be treated with a DMARD at onset of their disease. […] While there is no approved cure, doctors have found some success with treatments like bisphosphonates or diltiazem. […] Unlike PM and DM, inclusion body myositis (IBM) does not respond to steroids. There is currently no proven treatment for IBM. […] Recent trials have studied intravenous infusions of human immunoglobulin (IVIG) in IBM. […] People with IBM may find exercise, physiotherapy and occupational therapy helpful for coping with their condition. […] Although myositis can be treated with existing treatments and therapies, these are limited and the response rates can vary. New treatments are clearly needed.

• #65 Medical Management – Inclusion-Body Myositis (IBM) – Diseases | Muscular Dystrophy Association

  https://www.mda.org/disease/inclusion-body-myositis/medical-management

  There is currently no cure for inclusion body myositis (IBM). Disease management is focused on optimizing muscle strength and function using strategies such as exercise, physical therapy, occupational therapy, and speech therapy. […] Immunosuppressive steroid therapy is used to treat most idiopathic inflammatory myopathies (IIMs), the group of diseases that encompass IBM. This therapy, however, is typically ineffective in people with sporadic IBM (sIBM) and is not recommended in most cases. […] Treatment plans are typically individualized to meet the needs of the affected person and ongoing monitoring is required to optimize the treatment protocol.

• #66 Management of inclusion body myositis – UpToDate

  https://www.uptodate.com/contents/management-of-inclusion-body-myositis

  Management of inclusion body myositis […] The treatment and prognosis of IBM will be reviewed here. […] The primary goal of therapy in inclusion body myositis (IBM) is to optimize muscle strength and function. […] Based on the existing data, we only consider a trial of immunosuppressive medications in IBM patients with an atypical presentation or in patients with another autoimmune disease. […] Almost all patients with any degree of limitation in activities of daily living will benefit from physical and occupational therapy evaluation. […] Exercise is likely beneficial in all patients. […] However, there is limited evidence that some subgroups of patients may benefit from such therapy, in particular those with another systemic autoimmune disease such as Sjögren’s disease or systemic lupus erythematosus. […] Nonpharmacologic therapy — The optimal treatment for IBM is not known, and most interventions have demonstrated only limited benefit. Nonpharmacologic interventions such as physical therapy, occupational therapy, and/or speech therapy can be helpful in all patients to achieve the following:

• #67 Inclusion Body Myositis: Causes, Treatment, and Prognosis

  https://www.healthline.com/health/inclusion-body-myositis

  Inclusion body myositis treatment […] Theres no cure or gold-standard treatment for inclusion body myositis. But you can improve and manage symptoms, such as: mobility, swallowing, respiratory function, muscle weakness. […] A combination of the following therapies can help manage symptoms: […] Inclusion body myositis may be treated with medication, such as: alemtuzumab, azathioprine, cyclophosphamide, glucocorticoids, intravenous immunoglobulin, methotrexate. […] Various forms of therapy can improve quality of life. Therapies include: Physical therapy, including exercise, can help increase muscle strength and mobility. Occupational therapy involves learning techniques and methods for doing daily tasks. A speech therapist can help reduce the risk of choking caused by swallowing difficulties.

• #68 Inclusion Body Myositis: Causes, Treatment, and Prognosis

  https://www.healthline.com/health/inclusion-body-myositis

  Assistive devices can help prevent falls and support mobility. Your doctor might recommend using a: cane, brace, walker, wheelchair. […] If your swallowing difficulties are severe, you might need surgery. This may include myotomy or cricopharyngeal dilation. Myotomy involves a surgeon cutting the muscles of the cardia, which allows food and liquids to enter the stomach. In a cricopharyngeal dilation, a surgeon stretches the muscle at the top of the esophagus to allow food to pass easily. In severe cases, gastrostomy (feeding tube) might be needed. […] Theres no cure for inclusion body myositis, but treatments like medication, assistive devices, and physical therapy can help manage symptoms. These treatments can help improve quality of life and reduce the risk of complications.

• #69 Myositis: Symptoms, Causes, Diagnosis and Treatments

  https://www.webmd.com/a-to-z-guides/myositis-symptoms-treatments-prognosis

  The best way to treat myositis depends on whats causing it. […] If its due to an inflammatory condition, your doctor might prescribe drugs that suppress the immune system, including: Azathioprine (Imuran), Methotrexate, Prednisone. […] When myositis is caused by infection, its most often due to a virus and doesnt normally need specific treatment. Myositis caused by bacteria (which is uncommon) requires antibiotics to stop the infection from spreading. […] Rhabdomyolysis, which is a rare but serious complication of myositis, can lead to permanent kidney damage. People with rhabdomyolysis are usually hospitalized and treated with large amounts of IV fluids. […] When myositis is linked to a drug, treatment normally involves stopping the medication. For example, in cases of myositis caused by statin drugs, muscle inflammation usually improves within a few weeks of stopping the medicine.

• #70 Infectious Myositis Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1168167-treatment

  All medical care should be provided in conjunction with an infectious disease specialist and the primary care physician. […] HIV polymyositis: Corticosteroids remain the mainstay of treatment of polymyositis. […] Thiabendazole is effective if administered within 24 hours of infection. It has minimal effect in established infection. […] Optimal dosage has not been established. […] It can be combined with prednisone 40-60 mg/day in patients with severe pain and weakness. […] Benznidazole is a trypanocidal drug that is quite effective in the acute phase of the illness. […] It reduces cardiac complications and parasitemia and has been found to be beneficial in the early chronic phase. […] Successful treatment is evinced by serological tests remaining negative for at least 1 year after conclusion of treatment.

• #71 Infectious Myositis Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1168167-treatment

  Treatment comprises bed rest, intravenous fluids, and symptomatic management with antipyretics and analgesics. […] Antiviral agents such as amantadine could be considered in adults. […] Promptly administer systemic antibiotics. This could eliminate the need for surgical drainage in selected cases. […] The choice of antibiotic is determined by identification of the causative organism. […] Antibiotics initially are given intravenously until clinical improvement is noted, followed by oral antibiotics for a total course of 3 weeks (eg, cefazolin or ceftriaxone IV followed by cephalexin PO). […] High-dose penicillin G (4 million units) and clindamycin (800-900mg) IV. […] Use an antifungal agent such as amphotericin B or an echinocandin such as caspofungin. […] During the suppurative phase, abscess aspiration under ultrasonic or CT guidance may be required. Surgical drainage is especially necessary for large abscesses.

• #72 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  During the last years, exercise has been identified as an important adjunct part of the treatment for patients with IIM. Exercise may improve muscular metabolism, physical capacity, autonomy, and quality of life in patients with IIM. […] A main issue in treating patients with IIM is that, due the rarity and heterogeneity of the disease, randomized controlled trials are scarce and evidence-based guidelines/recommendations are lacking. Based on available data, systemic GCs are still the first-line therapy in these patients, and immunosuppressants should be considered to be added from the first phases of the disease in order to better control the disease activity and possibly to reduce the risk for GC-related AE.

• #73

  https://umiamihealth.org/en/treatments-and-services/arthritis-(rheumatology)-/myositis

  Myositis, which means muscle swelling, is a group of chronic diseases that causes muscle weakness thats often accompanied by pain. […] At University of Miami Health System, our rheumatologists have advanced experience treating all types of myositis. With locations throughout South Florida, you find expert care for myositis nearby. […] Doctors use a variety of medicines to stop the immune system from attacking healthy tissues, including: […] Physical therapy can help strengthen the muscles affected by myositis and improve your flexibility. A physical therapist can design a customized stretching and exercise program to prevent muscle wasting and improve the range of motion in your joints and muscles. […] The latest treatments for myositis and other rheumatic diseases. In addition to treating patients, our rheumatologists conduct research to find better approaches for managing the disease.

• #74

  https://umiamihealth.org/en/treatments-and-services/arthritis-(rheumatology)-/myositis

  Comprehensive care from a team of specialists. Myositis can affect different areas of your body, so our rheumatologists work with doctors in a full range of medical specialties to give you comprehensive, coordinated care such as dermatologists, vascular specialists, pulmonologists (lung doctors), ophthalmologists, and others. […] Expert diagnosis and personalized attention for myositis. Muscle weakness and fatigue can be caused by many things, so its important to work with a doctor who has experience identifying and treating myositis. […] Specialized care to improve your quality of life. Our rheumatologists work closely with physical therapists, pain management specialists, and other health care professionals to help manage symptoms such as muscle and joint pain, movement difficulties, and fatigue.

• #75 Myositis Program – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/rheumatology/myositis-program

  The Myositis Program at the University of Chicago Medicine is the only program in Illinois completely devoted to the care of patients with myositis. […] Once we arrive at a diagnosis and classify the type of myositis, we develop a comprehensive medical plan to help you control the disease and improve your quality of life. […] This may include: […] Immunosuppression medications such as corticosteroids (prednisone), methotrexate, mycophenolate mofetil, azathioprine, tacrolimus, immunoglobulins and rituximab […] Aggressive physical therapy to regain muscle function for those who are extremely disabled […] Guidance on sun protection for those with skin rashes sensitive to sunlight […] Oxygen and respiratory therapy for those with severe lung diseases.

• #76 Myositis Care – Los Angeles, CA | UCLA Health

  https://www.uclahealth.org/medical-services/rheumatology/myositis-care

  We provide highly specialized, comprehensive care for people with myositis, a rare disease that causes muscle, skin and lung inflammation. Our UCLA Health myositis team provides the highest level of individualized, targeted care for patients with myositis. We offer comprehensive evaluations for patients with suspected myositis and full-spectrum care for those with a confirmed diagnosis. Our specialists evaluate, diagnose and treat the many different types of myositis, including: Dermatomyositis, Polymyositis, Amyopathic dermatomyositis, Anti-synthetase syndrome, Immune-mediated necrotizing myositis, Inclusion body myositis, Overlap myositis. Early recognition of myositis symptoms is key to controlling the disease and lowering the risk of complications. We provide comprehensive, personalized evaluation and treatment for myositis that may include: Medications, Exercise, Clinical trial treatments. Our goal is to significantly decrease symptoms with high doses of medication and then lower the dosage to control the disease over time. With early, aggressive therapy, many patients with autoimmune myositis can lead typical lives. We offer full-spectrum evaluation and treatment for people with suspected or diagnosed myositis.

• #77 Myositis | Diagnosis & Disease Information

  https://www.rheumatologyadvisor.com/ddi/myositis/

  The most serious myositis complication is interstitial lung disease, which occurs in 20% to 80% of patients with myositis and is a frequent cause of death. […] According to the BSR guidelines, high-dose steroids; cyclosporin or tacrolimus; and cyclophosphamide or rituximab are recommended for patients with rapidly progressing interstitial lung disease.

• #78 Understanding Myositis: Treatments and Self-Care Tips | Los Angeles | Pacific Arthritis Care Center

  https://pacificarthritis.com/blog/understanding-myositis-treatments-and-self-care-tips/

  Understanding Myositis: Treatments and Self-Care Tips […] Myositis is a group of rare inflammatory diseases that cause muscle weakness, inflammation, and degeneration. At Pacific Arthritis, we are committed to helping patients understand and manage this complex condition. This blog will explore what myositis is, the available treatments, and essential self-care tips to help patients live better with this challenging disease. […] Treatments for Myositis […] While there is no cure for myositis, several treatments can help manage symptoms, reduce inflammation, and improve muscle strength and function. The treatment approach depends on the type and severity of myositis and individual patient factors. Common treatments include: […] 1. Medications: Corticosteroids: Prednisone and other corticosteroids are often the first line of treatment to reduce inflammation. Immunosuppressants: Drugs such as methotrexate, azathioprine, and mycophenolate mofetil help suppress the immune system and reduce inflammation. Biologic Agents: Rituximab and other biologics may be used for patients who do not respond well to standard treatments. Intravenous Immunoglobulin (IVIG): IVIG therapy can be effective for some patients, particularly those with dermatomyositis.

• #79 Understanding Myositis: Treatments and Self-Care Tips | Los Angeles | Pacific Arthritis Care Center

  https://pacificarthritis.com/blog/understanding-myositis-treatments-and-self-care-tips/

  2. Physical Therapy: A tailored exercise program can help maintain and improve muscle strength and flexibility. Physical therapists work with patients to create a safe and effective regimen. […] 3. Occupational Therapy: Occupational therapists help patients adapt their daily activities and use assistive devices to maintain independence and quality of life. […] 4. Speech and Swallowing Therapy: For patients experiencing difficulty swallowing or speaking, specialized therapy can help improve these functions. […] 5. Dietary Management: A balanced diet rich in anti-inflammatory foods can support overall health and well-being. A nutritionist can provide personalized dietary recommendations. […] How Pacific Arthritis Can Help […] At Pacific Arthritis, our team of expert rheumatologists is dedicated to providing comprehensive care for patients with myositis. We offer personalized treatment plans tailored to each patient’s unique needs, incorporating the latest advancements in rheumatology. Our multidisciplinary approach includes medication management, physical and occupational therapy, dietary counseling, and ongoing support to help patients achieve the best possible outcomes.

• #80 Myositis: Diagnosis & Treatment | Allegheny Health Network

  https://www.ahn.org/services/neuroscience/conditions/neuromuscular-disorders-care/myositis

  Myositis refers to a group of rare diseases that cause muscle inflammation, resulting in muscle fatigue and weakness. At Allegheny Health Network (AHN) Neuroscience Institute, our physicians are expertly trained to diagnose and treat the many forms of myositis, including dermatomyositis and polymyositis. We offer a range of effective therapies, from medication to rehabilitative care, to relieve your symptoms and improve your quality of life. […] Our neuroscience specialists work with you to tailor treatment to your symptoms and situation. This collaborative approach provides you with a high level of personalized care. […] We use a range of medications and rehabilitative therapies, including: […] Your physician will help determine which medications would most benefit you. Corticosteroids or other immunosuppressants work to reduce the body’s immune response, decreasing inflammation and improving certain symptoms.

• #81 Myositis: Diagnosis & Treatment | Allegheny Health Network

  https://www.ahn.org/services/neuroscience/conditions/neuromuscular-disorders-care/myositis

  Certain exercises or activities may strengthen muscles and help you complete daily activities more easily. Our knowledgeable, caring physical therapists customize a physical therapy plan for your needs. […] Our specially trained occupational therapists help you relearn how to complete daily activities that have become difficult, enhancing your independence at home or work. […] Dedicated speech therapists help you address symptoms that make it difficult to talk or swallow. […] Devices such as braces support you in everyday movements and help prevent injuries.

• #82 Myositis Treatment | Medications, Therapies & Care | Myositis India

  https://www.myositisindia.org/myositis-treatment

  In addition to medication and physical therapy, lifestyle modifications can also be helpful in managing myositis. For example, avoiding activities that worsen muscle weakness, such as carrying heavy loads or climbing stairs, and conserving energy by taking frequent rest breaks can help reduce symptoms. Eating a healthy, well-balanced diet and getting enough sleep can also support overall health and well-being. […] In conclusion, myositis is a rare and complex autoimmune disorder that requires a comprehensive approach to treatment and disease management. A combination of medications, physical therapy, and lifestyle modifications can help control symptoms, improve muscle strength, and promote overall health and well-being. Working closely with a healthcare team is essential to ensure the best possible outcomes for individuals with myositis.

• #83 Myositis support for members | HealthPartners

  https://www.healthpartners.com/insurance/members/health-programs/myositis/

  Home therapies In consultation with your doctor, things like yoga and acupuncture may help relieve symptoms. In addition, a healthy, balanced diet particularly one thats anti-inflammatory can go a long way. Gentle cold and heat therapy and massage are both good for your muscles, too. And make sure to rest whenever needed. […] Using a cane, walker or other assistive device You might find it easier to walk or get around with an assistive device. Your doctor or physical therapist can offer suggestions about what might work best for you.

• #84 Myositis: Symptoms, Causes, Diagnosis, and Treatment

  https://www.verywellhealth.com/myositis-overview-4778444

  When biologic agents are prescribed for treating myositis, they work by suppressing the immune systems response to bacteria, viruses, and other organisms. […] If your healthcare provider prescribes a biologic, they believe the benefit of taking the drug outweighs the risk of side effects. […] Exercise and physical therapy, rest, nutrition, and stress reduction may also help to reduce myositis symptoms. […] Regularly stretching can help to maintain your range of motion in weak arms and legs. […] Getting enough rest is another important part of your treatment plan. […] While there isn’t a specific diet recommended for myositis, an anti-inflammatory diet is easily adaptable and one that can benefit anyone living with an inflammatory condition. […] It is important that people with myositis find ways to manage daily stress.

• #85 Myositis | Arthritis Foundation

  https://www.arthritis.org/diseases/myositis

  No diet can cure myositis but adopting an anti-inflammatory diet may help. […] Following the physical therapists instructions for regular exercise keeps muscles strong and flexible and can prevent muscles from wasting away (atrophy). […] Sun protection may help manage skin and muscle symptoms. […] Managing stress can help boost the immune system and mood.

• #86 Treatment of Myositis – Johns Hopkins Myositis Center

  https://www.hopkinsmyositis.org/unique/treatment-myositis/

  As of now, there is no cure for myositis. However, management of the disease is critical in order to reduce inflammation caused by myositis and to prevent muscle weakness from progressing. Further, your doctor will recommend lifestyle changes so you can restore your strength. […] There are two approaches to treatment for myositis: medical treatment and lifestyle management changes. […] Your doctor will probably recommend a course of medical therapy using the following 2 classes of drugs: Corticosteroids (i.e., prednisone) and other drugs that suppress the immune system (immunosuppresants) may slow down the attack on healthy tissue and improve skin rash. […] You may also want to use nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin or ibuprofen for pain relief. […] After drug treatment takes effect, a program of regular stretching exercises prescribed by your doctor can help maintain range of motion in weakened arms and legs. […] Getting enough rest is an important component of managing myositis. […] What you eat can affect your overall health. […] It is imperative that myositis patients find outlets for the daily stress that most of us have in our lives.

• #87 Treatment of Myositis – Johns Hopkins Myositis Center

  https://www.hopkinsmyositis.org/unique/treatment-myositis/

  As of now, there is no cure for myositis. However, management of the disease is critical in order to reduce inflammation caused by myositis and to prevent muscle weakness from progressing. Further, your doctor will recommend lifestyle changes so you can restore your strength. […] There are two approaches to treatment for myositis: medical treatment and lifestyle management changes. […] Your doctor will probably recommend a course of medical therapy using the following 2 classes of drugs: Corticosteroids (i.e., prednisone) and other drugs that suppress the immune system (immunosuppresants) may slow down the attack on healthy tissue and improve skin rash. […] You may also want to use nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin or ibuprofen for pain relief. […] After drug treatment takes effect, a program of regular stretching exercises prescribed by your doctor can help maintain range of motion in weakened arms and legs. […] Getting enough rest is an important component of managing myositis. […] What you eat can affect your overall health. […] It is imperative that myositis patients find outlets for the daily stress that most of us have in our lives.

• #88 Myositis Treatment | Medications, Therapies & Care | Myositis India

  https://www.myositisindia.org/myositis-treatment

  In addition to medication and physical therapy, lifestyle modifications can also be helpful in managing myositis. For example, avoiding activities that worsen muscle weakness, such as carrying heavy loads or climbing stairs, and conserving energy by taking frequent rest breaks can help reduce symptoms. Eating a healthy, well-balanced diet and getting enough sleep can also support overall health and well-being. […] In conclusion, myositis is a rare and complex autoimmune disorder that requires a comprehensive approach to treatment and disease management. A combination of medications, physical therapy, and lifestyle modifications can help control symptoms, improve muscle strength, and promote overall health and well-being. Working closely with a healthcare team is essential to ensure the best possible outcomes for individuals with myositis.

• #89 Myositis Treatment | Medications, Therapies & Care | Myositis India

  https://www.myositisindia.org/myositis-treatment

  In addition to medication and physical therapy, lifestyle modifications can also be helpful in managing myositis. For example, avoiding activities that worsen muscle weakness, such as carrying heavy loads or climbing stairs, and conserving energy by taking frequent rest breaks can help reduce symptoms. Eating a healthy, well-balanced diet and getting enough sleep can also support overall health and well-being. […] In conclusion, myositis is a rare and complex autoimmune disorder that requires a comprehensive approach to treatment and disease management. A combination of medications, physical therapy, and lifestyle modifications can help control symptoms, improve muscle strength, and promote overall health and well-being. Working closely with a healthcare team is essential to ensure the best possible outcomes for individuals with myositis.

• #90 Myositis support for members | HealthPartners

  https://www.healthpartners.com/insurance/members/health-programs/myositis/

  Home therapies In consultation with your doctor, things like yoga and acupuncture may help relieve symptoms. In addition, a healthy, balanced diet particularly one thats anti-inflammatory can go a long way. Gentle cold and heat therapy and massage are both good for your muscles, too. And make sure to rest whenever needed. […] Using a cane, walker or other assistive device You might find it easier to walk or get around with an assistive device. Your doctor or physical therapist can offer suggestions about what might work best for you.

• #91 New Treatments For Myositis | An In-depth Guide By Re-origin

  https://www.re-origin.com/articles/new-treatments-for-myositis

  Myositis refers to a group of autoimmune diseases that cause chronic inflammation in the muscles, leading to muscle weakness, fatigue, and sometimes damage to other organs. […] Recent advancements in medical research have led to new treatment options, offering hope to myositis patients. […] Emerging research is exploring the potential of brain retraining and neuroplasticity to help manage myositis symptoms. […] Brain retraining techniques like mindfulness, cognitive behavioral therapy, and neurofeedback can help patients reduce stress and improve the brain-body connection, ultimately promoting muscle healing and reducing inflammation. […] Monoclonal antibody (mAb) therapies are proving to be a significant advancement in the treatment of myositis, particularly for refractory patients—those who do not respond to traditional therapies.

• #92 New Treatments For Myositis | An In-depth Guide By Re-origin

  https://www.re-origin.com/articles/new-treatments-for-myositis

  Intravenous immune globulin (IVIG) therapy is another promising treatment option for myositis patients, especially those with severe or refractory myositis. […] New treatments aim to modulate T-cell activation and promote immune regulation. […] To reduce the progression of lung disease, new treatments targeting the immune pathways that contribute to lung inflammation, such as B-cell activating factor (BAFF) inhibitors, are being explored. […] Clinical trials play a crucial role in evaluating the effectiveness of new treatments for myositis. […] The treatment landscape for myositis is rapidly evolving, with new therapies offering hope to patients who have struggled with the disease for years. […] New therapies, such as IVIG and rituximab, have shown that muscle function and muscle strength can improve over time as inflammation decreases and the immune system is better regulated. […] With the advent of new treatments, such as monoclonal antibodies and brain retraining, long-term remission is possible.

• #93 Congress of Clinical Rheumatology Annual Meeting

  https://www.healio.com/news/rheumatology/20230508/exciting-time-for-myositis-drug-pipeline-shifts-from-organcentric-to-targeted-therapy

  DESTIN, Fla. Although new targets and therapies are on the horizon, current myositis treatment strategies rely on treating impacted organ groups, according to a speaker at the 2023 Congress of Clinical Rheumatology-East. […] The current treatment strategy for patients with myositis is largely dependent upon the involved organ systems for each individual patient. […] The first line will be glucocorticoids, and we usually do one milligram per kilogram, Paik said. It is really dependent upon, I think, the extent of disease activity, how high you are going to go. […] In addition to glucocorticoids, a second agent may be added, depending on the impacted organ groups. For example, patients with significant joint, skin and muscle involvement in their myositis may do well with methotrexate, while patients with lung, skin and muscle involvement may do better with azathioprine or mycophenolate mofetil, Paik said.

• #94 Congress of Clinical Rheumatology Annual Meeting

  https://www.healio.com/news/rheumatology/20230508/exciting-time-for-myositis-drug-pipeline-shifts-from-organcentric-to-targeted-therapy

  There is really no head-to-head trial comparing these three standard-of-care medications, Paik said. We definitely need to draft some consensus guidelines. […] Specifically considering dermatomyositis, Paik mentioned ravulizumab, a monoclonal antibody that targets the complement C5 protein. […] Regarding immune-mediated necrotizing myopathy, Paik noted FCRN inhibitors. Specifically, she called out efgartigimod (ArgenX). […] Finally, looking at inclusion body myositis, Paik called attention to ABC008 (Abcuro), a first-in-class, humanized monoclonal antibody that binds to KLRG1 to deplete certain T cells, Paik said. […] A phase 2 trial investigating the therapy is set to initiate in September, Paik said.

• #95 Stromal vascular fraction in the treatment of myositis | Cell Death Discovery

  https://www.nature.com/articles/s41420-023-01605-9

  Muscle regeneration is a physiological process that converts satellite cells into mature myotubes under the influence of an inflammatory environment progressively replaced by an anti-inflammatory environment, with precise crosstalk between immune and muscular cells. […] Immunosuppressive treatments can block the first part of the process, but sometimes muscle remains weakened, or even still deteriorates, due to the exhaustion of its capacities. For patients refractory to immunosuppressive therapies, mesenchymal stem cells have shown interesting effects but their use is limited by their availability. Stromal vascular fraction, which can easily be extracted from adipose tissue, has shown good tolerance and possible therapeutic benefits in several degenerative and autoimmune diseases. […] We review herein the current knowledge on the mechanisms of action of stromal vascular fraction and hypothesise on how it could potentially respond to some of the unmet treatment needs of refractory myositis.

• #96 Stromal vascular fraction in the treatment of myositis | Cell Death Discovery

  https://www.nature.com/articles/s41420-023-01605-9

  Therapeutic options for inflammatory myopathies are predominantly based on immunosuppressive treatments, which are sometimes insufficient to regulate the different features of these complex pathologies. […] Adipose tissue-derived stem cells and stromal vascular fraction have immunomodulatory, anti-fibrotic, proangiogenic and regenerative properties that could be exploited for the treatment of refractory or relapsed myositis. […] However, the mechanisms behind these effects are still insufficiently understood and more preclinical studies are required before their clinical use. […] Cell therapies have sometimes shown long-term beneficial effects. […] More recently, the discovery of the immunomodulatory effects of Mesenchymal Stem Cells (MSC) from Bone Marrow (BM-MSC) or Umbilical Cord Blood (UC-MSC), in addition to their well-known regenerative effect, has led to their use for the treatment of patients with refractory autoimmune diseases, including myositis. […] Adipose tissue is another source of MSC. They can be extracted safely and in large quantities from a lipoaspirate by enzymatic digestion or mechanical isolation for Stromal Vascular Fraction (SVF), followed by replicative cultures of adherent cells for Adipose-Derived Stem Cells (ADSC). […] If ADSC are known to possess immunomodulatory, proangiogenic, anti-fibrotic and regenerative capacities like MSC from other tissues, SVF share similar properties and is easier to prepare.

• #97 Current Treatment for Myositis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6299051/

  During the last years, exercise has been identified as an important adjunct part of the treatment for patients with IIM. Exercise may improve muscular metabolism, physical capacity, autonomy, and quality of life in patients with IIM. […] A main issue in treating patients with IIM is that, due the rarity and heterogeneity of the disease, randomized controlled trials are scarce and evidence-based guidelines/recommendations are lacking. Based on available data, systemic GCs are still the first-line therapy in these patients, and immunosuppressants should be considered to be added from the first phases of the disease in order to better control the disease activity and possibly to reduce the risk for GC-related AE.

• #98 Myositis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/24170-myositis

  Myositis makes your immune system attack your muscles. […] Theres no cure for myositis, but in most cases, treatment can put it into remission. […] Your healthcare provider will treat the symptoms youre experiencing. Theyll also recommend exercises like stretching and physical movements that can help strengthen your affected muscles between episodes of myositis symptoms. […] The sooner you begin treatment, the more likely it is you can avoid having severe complications. […] Theres no cure for myositis. Your provider will treat your symptoms to reduce their impact on your daily routine. Their goal will be to treat your symptoms until the myositis goes into remission (when theres little or no inflammation in your muscles). Typical treatments for myositis include: Corticosteroids, Immunosuppressants, Intravenous immunoglobulin. […] Even though theres no cure for myositis, your healthcare provider will help you find treatments and physical therapy exercises that will manage your symptoms.

• #99

  https://link.springer.com/article/10.1007/s40674-018-0106-2

  The purpose of this review was to give an update on treatment modalities for patients with idiopathic inflammatory myopathies, or shortly myositis, excluding the subgroup inclusion body myositis, based on a literature survey on therapies used in myositis. […] Glucocorticoid (GC) in high doses is still the first-line treatment of patients with myositis. There is a general recommendation to combine GCs with another immunosuppressive agent in the early phase of disease to better control disease activity and possibly to reduce the risk for GC-related side effects. Furthermore, combining pharmacological treatment with individualized and supervised exercise can be recommended based on evidence. […] Immunosuppressive treatment in combination with exercise is recommended for patients with myositis to reduce disease activity and improve muscle performance.

• #100 Treatment in myositis | Nature Reviews Rheumatology

  https://www.nature.com/articles/nrrheum.2018.42

  Managing myositis and its systemic complications represents a challenge to the clinicians providing care as patients often have severe muscle weakness, notable skin rashes and life-threatening organ involvement. […] Conventional therapies include glucocorticoids usually in combination with another or multiple immunosuppressive agents, but biologic therapies targeting immunopathogenic pathways are being increasingly utilized. […] Exercise, once considered controversial in the management of myositis, has emerged as an important adjunct in treating patients with myositis; molecular evidence suggests that exercise regimens are both safe and anti-inflammatory. […] Nevertheless, a multitude of immunosuppressive and immunomodulatory agents are available to clinicians managing myositis, and the emergence of biologic agents targeting potential pathogenic pathways offers hope for mitigating or curing this enigmatic group of diseases. […] Paradigm shifts in the nonpharmacological approach to treat myositis have also occurred as more aggressive exercise regimens have shown benefit in patients, even those with active disease.

• #101 LIVING WITH MYOSITIS: HOW TO COPE WITH MUSCLE INFLAMMATION | Mya Care

  https://myacare.com/blog/living-with-myositis-how-to-cope-with-muscle-inflammation

  Myositis cannot be cured, however, treatment can lessen symptoms, avert complications, and enhance a patient’s quality of life. […] It is important to consult with your healthcare provider to receive an accurate diagnosis and tailored treatment plan. The treatment plan may vary depending on the type and severity of the disease, as well as the individuals response and tolerance to the medications. […] Some of the treatment options for myositis include: […] Medications: These drugs aim to suppress the immune system and reduce inflammation. They include corticosteroids such as prednisone, immunosuppressants such as methotrexate or azathioprine, biologics such as rituximab or tocilizumab, and immunoglobulin therapy. […] Therapy: Physical therapy, occupational therapy, and speech therapy can help maintain muscle strength and flexibility, slow muscle atrophy, and improve function and mobility. […] Lifestyle changes: These adjustments can help manage the symptoms and enhance general health and well-being. […] The key to managing myositis is to seek early diagnosis and treatment, follow the doctors recommendations, and adopt a healthy lifestyle.

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