bone, joint, and muscle disorders
Autoimmune Myositis
Treatment of Autoimmune Myositis
Corticosteroids Immunosuppressive drugs Sometimes immune globulin Modest restriction of activities when the muscle inflammation is most intense often helps. Generally, the corticosteroidprednisoneis given by mouth in high doses. This drug slowly improves strength and relieves pain and swelling, controlling the disease. People who have severe disease with swallowing difficulty or weakness of the muscles needed for breathing are given a corticosteroid such asmethylprednisoloneby vein. Many adults must continue takingprednisone(at the lowest effective dose) for months. To monitor how the disorder is responding to corticosteroid treatment, doctors periodically do a blood test to measure the levels of muscle enzymes. The levels usually fall to normal or near normal and muscle strength returns after about 6 to 12 weeks. MRI may also show areas of inflammation and help the doctor determine how the disorder is responding to treatment. Once enzyme levels have returned to normal,prednisonecan be gradually reduced. If muscle enzyme levels rise, the dose is increased. Although doctors typically give corticosteroids first when treating people who have autoimmune myositis, these drugs do cause side effects (for example, high blood sugar, mood swings, cataracts, risk of fractures, and glaucoma), especially if they are given at high doses for a long time. Therefore, to minimize long-term corticosteroid use and the side effects, an immunosuppressive drug (such asmethotrexate,tacrolimus,azathioprine,mycophenolatemofetil,rituximab, orcyclosporine) may be given in addition toprednisone. Another possible treatment is immune globulin (a substance that contains large quantities of many antibodies) given by vein (intravenously). Some people receive a combination of corticosteroids, immunosuppressive drugs, and immune globulin. When muscle weakness is associated with cancer, it usually does not respond well toprednisone. However, the muscle weakness usually lessens in severity if the cancer can be successfully treated. People who take corticosteroids are at risk of fractures related to Osteoporosis . To prevent osteoporosis, these people are given the drugs used to treat osteoporosis, such as (see Prevention ) and vaccines against common infections such as People who have autoimmune myositis are at increased risk of and are closely monitored by doctors. 