title: [Treatment and prognosis].
abstract: Diagnosis should include mandatory muscle biopsy to identify inclusion body myositis. Most forms of inflammatory myopathies are still treated similarly, although treatment strategies remain empirical and controlled trials are few. Muscle strength and CPK levels remain the most frequently used measures to monitor disease activity and response to therapy. Corticosteroids are the main pillar of drug therapy but simultaneous use of corticosteroid-sparing drugs may be considered from the start. The most frequently used drugs for combined therapy are methotrexate, azathioprine and antimalarials in cases of dermatomyositis. In refractory cases, especially if life threatening, rituximab has appeared to be effective although there are no controlled trials, and there is some consensus that this should be used prior to Immunoglobulin. Anti TNF antibodies have not been useful in these diseases. Cyclosporin (especially with lung involvement) and Mofetil mycophenolate may also have a role in non responding cases. Treatment of inclusion body myositis remains unsatisfactory.
authors.affiliation: Sección de Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Fundacion Dr. Pedro M. Catoggio para el Progreso de la Reumatología, Buenos Aires, Argentina; Instituto Universitario Escuela de Medicina Hospital Italiano de Buenos Aires, Fundacion Dr. Pedro M. Catoggio para el Progreso de la Reumatología, Buenos Aires, Argentina. luis.catoggio@hospitalitaliano.org.ar
authors.forename: Luís J
authors.initials: LJ
authors.lastname: Catoggio
authors.forename: Enrique R
authors.initials: ER
authors.lastname: Soriano
authors.forename: Javier E
authors.initials: JE
authors.lastname: Rosa