Ab1804

Treatment of the idiopathic inflammatory myopathies: A retrospective analysis of 63 Caucasian patients longitudinally followed at a single center

M. Mosca¹, R. Neri², G. Pasero², S. Bombardieri¹

¹Clinical Immunology Unit and ²Rheumatology Unit, Department of Internal Medicine, University of Pisa, Italy.

ABSTRACT
Objective

To analyze the therapies used over the past 20 years at a single center to treat patients with idiopathic inflammatory myopathies (IIM), and to compare their effectiveness.

Methods
Sixty-three Caucasian IIM patients were selected for this study based on the following parameters: (i) a definite diagnosis of IIM; (ii) a follow-up period of at least one year; and (iii) a complete record of clinical and serological data for the course of the follow-up. The following data were collected from the patients' records: the first choice and subsequent therapies, the patient's response to these treatments, the outcome at the end of the follow-up.

Results
Two therapeutic approaches were identified: steroids alone and the combination of steroids with immunosuppressive drugs. Of the 63 patients studied, 36 received steroids alone and 27 received steroids plus immunosuppressors. Sixteen patients did not respond to the initial therapy, 33 showed a stable response, and 14 experienced a relapse in disease activity during the follow-up. No statistically significant differences among these 3 groups of patients were observed with respect to sex, age at disease onset, diagnosis, CPK levels at disease onset, and therapeutic approach.

Conclusion
Corticosteroids represent the mainstay of IIM therapy, both as the first choice treatment and as maintenance therapy. The use of immunosuppressive agents should be restricted to those patients with severe contraindications to steroid treatment.

Keywords
Idiopathic inflammatory myopathies, therapy, corticosteroids, immunosuppressive drugs.

Please address correspondence and reprint requests to: M. Mosca, M.D., Clinical Immunology Unit, Department of Internal Medicine, University of Pisa, via Roma 67, 56126 Pisa, Italy.
E-mail: marta@sssup.it