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Neuromuscul Disord. 2015 Aug;25(8):625-31. doi: 10.1016/j.nmd.2015.04.013. Epub 2015 May 7.

Disease course and therapeutic approach in dermatomyositis: A four-center retrospective study of 100 patients.

Author information

1
Department of Neurology, University of Utah, Salt Lake City, UT, USA; Department of Neurology, University of Rochester, Rochester, NY, USA. Electronic address: Nicholas.johnson@hsc.utah.edu.
2
Department of Neurology, Ohio State University, Columbus, OH, USA.
3
Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA.
4
Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
5
Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA.
6
Department of Neurology, University of Rochester, Rochester, NY, USA; Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA.
7
Department of Neurology, University of Rochester, Rochester, NY, USA.

Abstract

Dermatomyositis is a life-altering inflammatory disorder of skin and muscle. Details regarding the natural course of this disorder, the effects of specific therapies on its progression, and the optimal therapeutic dosage and duration of prednisone are limited. We performed a retrospective medical record review of dermatomyositis patients at four medical centers. All patients were over the age of 21 and had a clinical diagnosis of dermatomyositis with pathological confirmation. We reviewed average muscle strength, corticosteroid use, creatine kinase levels, and supplemental immunosuppressant use during the 36-month period following each patient's initial assessment. One hundred patients participated with an average age of 50.1 years. Average muscle strength improved and prednisone requirements lessened six months after initial assessment. There was no difference in the mean change in muscle strength or cumulative corticosteroid use over 36 months among those initially treated with methotrexate, mycophenolate mofetil, pulse IVIG, or azathioprine. There was a 5% mortality rate in dermatomyositis patients due to infections. Treated dermatomyositis patients demonstrate the most significant improvement in strength during the first six-to-twelve months following their initial clinical assessment. Additional prospective studies are needed to determine the relative benefit of select immunosuppressant agents in preserving strength and reducing corticosteroid use in dermatomyositis.

KEYWORDS:

Comparative effectiveness; Dermatomyositis; Immunosuppression; Inflammatory myopathies

PMID:
26022999
PMCID:
PMC4519354
DOI:
10.1016/j.nmd.2015.04.013
[Indexed for MEDLINE]
Free PMC Article

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