Intravenous immunoglobulin as add on treatment with mycophenolate mofetil in severe myositis.

Abstract

OBJECTIVES:

To report the use of intravenous immunoglobulin (IVIg) and mycophenolate mofetil (MMF) in polymyositis (PM) and dermatomyositis (DM).

METHODS:

We performed an open study in PM and DM with active disease. Indications for treatment were: steroid-dependency, refractoriness to steroid and/or immunosuppressants, and life-threatening disease. IVIg was used at 2 g/kg in monthly cycles for six months and then each other month for other three cycles. MMF was slowly titrated to 30 mg/kg/day orally. Parameters employed to follow patients were the Medical Research Council (MRC) scale, the modified Rankin score, CK serum levels and daily prednisone dose.

RESULTS:

Seven patients were studied (4PM, 3DM). All were females, with a mean age of 49 years. All of them achieved a complete remission and, at the last follow-up visit, significant differences in MRC score, modified Rankin score, CK levels, and the daily maintenance prednisone dose were documented. No relevant side effects were observed.

CONCLUSION:

IVIg as add on treatment with MMF is effective in severe and refractory myositis, moreover as safe and steroid-sparing agent.

• Authors: Maria Giovanna Danieli, Lucia Calcabrini, Vincenzina Calabrese, Annalisa Marchetti, Francesco Logullo, Armando Gabrielli
• Journal: Autoimmunity reviews (Autoimmun Rev) Vol. 9 Issue 2 Pg. 124-7 (Dec 2009) ISSN: 1873-0183 [Electronic] Netherlands
• PMID: 19386287 (Publication Type: Journal Article)

Chemical References

• Immunoglobulins, Intravenous
• Immunosuppressive Agents
• Creatine Kinase
• Mycophenolic Acid

Topics

• Aged
• Creatine Kinase (blood)
• Deglutition Disorders
• Dermatomyositis (blood, drug therapy, immunology, physiopathology)
• Disease Progression
• Drug Resistance
• Drug Therapy, Combination (adverse effects)
• Dyspnea
• Female
• Follow-Up Studies
• Humans
• Immunoglobulins, Intravenous (administration & dosage, adverse effects)
• Immunosuppressive Agents (administration & dosage, adverse effects)
• Middle Aged
• Mycophenolic Acid (administration & dosage, adverse effects, analogs & derivatives)
• Polymyositis (blood, drug therapy, immunology, physiopathology)
• Remission Induction