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Polymyositis Management
Aka: Polymyositis Management, Dermatomyositis Management
- See Also
- Dermatomyositis
- Polymyositis
- Management: General Measures
- Prevent atrophy and contractures in Myositis
- Passive Stretching and Splinting
- Strength-building after inflammation decreases
- Dermatomyositis
- Skin Lesions
- See Pruritus Management
- Consider high potency Topical Corticosteroid
- Avoid Sun Exposure (especially in photosensitivity)
- Sunscreen
- Protective clothing
- Management: Systemic Medications
- Prednisone
- Dose
- Adults: 40-60 mg/day
- Children: 1 to 2 mg/kg/day
- Protocol
- Administer bid until serum Creatine Kinase normal
- Convert to single daily dose
- Reduce dose by 25% every 4 weeks down to 10 mg/day
- Continue low dose (5-10 mg in adults) for 1 year
- Other Immunosuppressants
- Indications
- Strength refractory to Prednisone after 3 months
- No improvement in objective Muscle Strength
- Differentiate from steroid Myopathy
- Neck flexor strength unchanged steroid Myopathy
- Immunosuppressant Options
- Methotrexate
- Azathioprine (Imuran)
- Other agents in refractory cases (TNF-alpha inhibitors, Cytoxan)
- Other medications
- IVIG
- Calcinosis management
- Calcium Channel Blockers (e.g. Diltiazem)
- Bisphosphonates
- References
- Joffe (1993) Am J Med 94:379-87 [PubMed]
- Koler (2001) Am Fam Physician 64(9):1565-72 [PubMed]
- Oddis (2000) Curr Opin Rheumatol 12(6):492-7 [PubMed]
- Pachman (1995) Pediatr Clin North Am 42:1071-98 [PubMed]