Treatment of the idiopathic inflammatory myopathies: a retrospective analysis of 63 Caucasian patients longitudinally followed at a single center.
OBJECTIVE
To analyze the therapies used over the past 20 years at a single center to treat patients with idiopathic inflammatory myopathies (IIM), and to compare their effectiveness.


METHODS
Sixty-three Caucasian IIM patients were selected for this study based on the following parameters: (i) a definite diagnosis of IIM; (ii) a follow-up period of at least one year; and (iii) a complete record of clinical and serological data for the course of the follow-up. The following data were collected from the patients' records: the first choice and subsequent therapies, the patient's response to these treatments, the outcome at the end of the follow-up.


RESULTS
Two therapeutic approaches were identified: steroids alone and the combination of steroids with immunosuppressive drugs. Of the 63 patients studied, 36 received steroids alone and 27 received steroids plus immunosuppressors. Sixteen patients did not respond to the initial therapy, 33 showed a stable response, and 14 experienced a relapse in disease activity during the follow-up. No statistically significant differences among these 3 groups of patients were observed with respect to sex, age at disease onset, diagnosis, CPK levels at disease onset, and therapeutic approach.


CONCLUSIONS
Corticosteroids represent the mainstay of IIM therapy, both as the first choice treatment and as maintenance therapy. The use of immunosuppressive agents should be restricted to those patients with severe contraindications to steroid treatment.
Mosca
M
M
Clinical Immunology Unit, University of Pisa, Italy. marta@sssup.it
Neri
R
R
Pasero
G
G
Bombardieri
S
S
D017668:Age of Onset; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D009220:Myositis / Q000188:drug therapy*; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D001379:Azathioprine; D008775:Methylprednisolone; D008727:Methotrexate