title: Repository Corticotropin Injection for Treatment of Idiopathic Inflammatory Myopathies.
abstract: Idiopathic inflammatory myopathies are a group of systemic autoimmune diseases that involve inflammation of skeletal muscle. The two most common forms are dermatomyositis and polymyositis, the former of which entails a skin component. There are few approved therapeutics available for treatment of this group of diseases and the first-line therapy is usually corticosteroid treatment. Considering that a large proportion of patients do not respond to or cannot tolerate corticosteroids, additional treatments are required. There are second-line therapies available, but many patients are also refractory to those options. H.P. Acthar® Gel (repository corticotropin injection [RCI]) is a melanocortin peptide that can induce steroid-dependent effects and steroid-independent effects. Herein, we present a series of cases that involved the use of RCI in the management of dermatomyositis and polymyositis. RCI treatments resulted in improvement in three of four patients, despite failure with previous therapies. The use of RCI did not exacerbate any comorbidity and no significant changes in blood pressure, weight, or glycemic control were observed. Overall, these results are encouraging and suggest that randomized, controlled clinical trials applying RCI to dermatomyositis and polymyositis are warranted.
authors.affiliation: Arthritis and Osteoporosis Center of Richmond, 9600 Patterson Avenue, Richmond, VA 23229, USA; Department of Pediatrics, University of Virginia Children's Hospital, Box 800386, Charlottesville, VA 22908, USA.
authors.forename: Aarat
authors.identifier: 0000-0002-9756-2274
authors.initials: A
authors.lastname: Patel
authors.affiliation: Dermatology Associates of Virginia, P.C., 10800 Midlothian Turnpike, Suite 309, Richmond, VA 23226, USA.
authors.forename: Georgia
authors.initials: G
authors.lastname: Seely
authors.affiliation: Division of Rheumatology and Clinical Immunology, University of Pittsburgh, BST S725, 3500 Terrace Street, Pittsburgh, PA 15217, USA.
authors.forename: Rohit
authors.initials: R
authors.lastname: Aggarwal