Adult-onset polymyositis-dermatomyositis: description of 25 patients with emphasis on treatment.
A retrospective study of 25 patients with polymyositis-dermatomyositis (PM-DM) is analyzed with special attention to the effects of therapy and follow-up. All patients (100%) complained of muscle weakness and 68% of these demonstrated typical skin changes of DM. All patients, except 2, received corticosteroids at the onset of the disease, 23 were treated with azathioprine, 7 received cyclophosphamide, 4 methotrexate, and 1 had total body irradiation. Among the patients adequately treated with azathioprine, 75% had a good response, but 5 patients did not improve. Cyclophosphamide was used subsequently in 2, with a satisfactory response in 1. Another patient had a striking response to oral methotrexate, and total body irradiation helped to improve another patient. Although high dose corticosteroids were the preferred starting medication for the treatment of PM-DM, it is important to detect those patients who do not respond adequately and/or develop side effects. In these circumstances, the prompt use of immunosuppressive agents appears justified.
Ramírez
G
G
Lupus Arthritis Research Unit, Rayne Institute, St Thomas' Hospital, London, UK.
Asherson
R A
RA
Khamashta
M A
MA
Cervera
R
R
D'Cruz
D
D
Hughes
G R
GR
D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D003882:Dermatomyositis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009220:Myositis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D013256:Steroids / Q000627:therapeutic use
D013256:Steroids; D003520:Cyclophosphamide; D001379:Azathioprine; D008727:Methotrexate