Treating Idiopathic Inflammatory Myopathies
IIM are a varied group of diseases, but they are generally treated in a similar way, with a few exceptions. There is no specific pharmacological treatment for inclusion body myositis (IBM) in its sporadic form; treatment with immunosuppressive drugs is reserved for the other types as it has not been shown to be effective in IBM.
Non-pharmacological treatment
Bed rest. This may be necessary, especially in the phases when the disease is intensely active, although an early aerobic exercise programme is recommended to prevent cramps, as is a suitable rehabilitation programme and sufficient protein intake, as patients lose muscle mass.
Elevate the head of the bed and use thickening solutions to facilitate swallowing in patients who experience difficulties doing this.
Address other problems (co-morbidities) that may arise, such as preventing osteoporosis, as well as controlling blood sugar levels, arterial blood pressure, and alterations in the lipid profile. To prevent infections it is necessary to bring the vaccine schedule up to date and use the approved prophylactic measures for latent tuberculosis or infections with the hepatitis B virus, chicken pox/zoster virus, and Pneumocystis jirovecii (a so-called opportunistic infection).
Pharmacological treatment
Glucocorticoids (cortisone) are the treatment of choice for idiopathic inflammatory myopathies. Immunosuppressants, intravenous immunoglobulins, and biological agents are also prescribed.
New therapies
It is very likely that in the near future, new drugs (within the group usually known as biological agents) will be developed, meaning the treatments will be more effective and less toxic.
Treatment complications
The side effects of these steroids include high blood pressure, weight gain, increased hair growth, stretch marks on the abdomen, diabetes of worsening of it and fibre atrophy. Osteoporosis commonly develops, particularly in post-menopausal women, so it is essential to start treatment with bisphosphonates, calcium, and vitamin D and do a bone density.
Immunosuppressive drugs confer a certain risk of contracting infectious diseases, some of which are quite serious.
Treatment with intravenous immunoglobulins involves no special risks except for mild and transient reactions (headache, heat, joint pain) during its administration.
Substantiated information by:
Published: 25 November 2020
Updated: 25 November 2020
Subscribe
Receive the latest updates related to this content.
Thank you for subscribing!
If this is the first time you subscribe you will receive a confirmation email, check your inbox