Polymyositis--treatment and prognosis. A study of 107 patients.
One hundred and seven patients with polymyositis or dermatomyositis were followed for an average of 5 years. In 100 patients it was possible to evaluate the effect of treatment with steroids or a combination of steroids and immunosuppressive drugs. Fifty patients improved, 50 did not. Compared with the treatment-resistant group the treatment-responsive patients were of younger age, did not have an associated malignancy or cardiac disease and began treatment within 24 months after the onset of muscular weakness. In the treatment-responsive group the degree of improvement was correlated to the mean dose of steroids given during the first 3 months of treatment. Eighty-seven per cent of surviving responsive patients had no or slight disability at the end of the investigation. The mortality rate was 23% and was highest in the treatment-resistant group. Comparison between different treatment programs was possible and based on the results, a treatment schedule could be recommended. The principles of this schedule are: During the first month high doses of prednisone or prednisolone should be given daily. From the second month, an alternate-day administration can be employed. Tapering to maintenance dose should be gradual and slow. The treatment period should be long. The mean duration in the present series was 27 months.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009220:Myositis / Q000188:drug therapy* / Q000401:mortality; D010043:Outcome and Process Assessment, Health Care; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D011379:Prognosis; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use; D013997:Time Factors
D007166:Immunosuppressive Agents; D013256:Steroids; D011239:Prednisolone