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Inclusion Body Myositis.

Barohn1, Amato

  • 1Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75235-8897, USA.

Current Treatment Options in Neurology
|November 30, 2000
PubMed
Summary
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Inclusion body myositis (IBM) treatment is generally not recommended with immunosuppressants. A short trial of prednisone, potentially with methotrexate, may be considered for select patients with IBM.

Area of Science:

  • Neurology
  • Immunology

Background:

  • Inclusion body myositis (IBM) is a rare, progressive neuromuscular disorder.
  • IBM is typically resistant to immunosuppressive treatments.

Purpose of the Study:

  • To evaluate the efficacy of immunosuppressive therapy in patients with Inclusion body myositis.
  • To provide guidance on the potential use and limitations of pharmacologic interventions for IBM.

Main Methods:

  • A 3- to 6-month trial of oral prednisone (100 mg/d, then 100 mg every other day) was considered.
  • If no improvement, oral methotrexate (10-15 mg/wk) was added for 6-12 months.
  • Intravenous immunoglobulin (IVIG) was not recommended due to cost and limited evidence.

Main Results:

Related Experiment Videos

  • A minority of IBM patients may experience partial, transient responses to therapy.
  • Prednisone alone or with methotrexate showed limited objective clinical improvement in strength over 6-12 months.
  • Discontinuation of pharmacologic therapy was advised if no significant improvement was observed.

    • Conclusions:

    • Immunosuppressive therapy is generally not advised for Inclusion body myositis.
    • A carefully monitored trial of prednisone, possibly combined with methotrexate, can be attempted for patients willing to accept potential side effects.
    • Intravenous immunoglobulin is not recommended for IBM treatment.