[Therapeutic advances in neuromuscular diseases]

The etiology of neuromuscular diseases varies widely as does their treatment. This study reports the treatment of patients with neuromuscular disease of autoimmune origin in addition to the therapy of muscular dystrophies. The mechanisms of action of the immunosuppressive drugs (glucocorticoids, azathiaprin, cyclosporin, methotrexate, chlorambucil, cyclophosphamide) and immunomodulators (plasmapheresis, Ig ev) currently used are analyzed, as are their indications, management and the methods which allow the control of therapeutic efficacy. The immunotherapies presently in experimental phases are also reviewed (oral tolerance, inhibition of cytokines, chemokines, etc.). Both molecular therapy (myoblast transplantation, genetic therapy, gentamycin) and anabolizing drugs administered after the favorable results of clinical trials (glucocorticoids, oxandrolone) and undergoing controlled clinical studies (albuterol, creation, etc.) on the treatment of muscular dystrophies are evaluated. Lastly, symptomatic treatments which improve the quality of life of patients with muscular dystrophy are analyzed.