[Immunosuppressant treatment in refractory myositis. Our experience]

We report our experience of treating polymyositis (PM) and dermatomyositis (DM) with prednisone and immunosuppressants (methotrexate [MTX], cyclophosphamide [CTX], cyclosporine A [CsA], mycophenolate mofetil [MMF] and intravenous immunoglobulins [IVIg]). We revised our series of 63 subjects with primary PM or DM and overlap myositis, diagnosed according to the Bohan and Peter criteria. We used a standardised protocol to evaluate patients, and assess treatment response. Complete remission was achieved in 26, 60, 82, and 85% of subjects treated with MTX, CTX, CsA-IVIg and MMF-IVIg, respectively. Patients receiving CsA or MMF plus IVIg had a significantly higher probability of maintaining complete remission at long-term follow-up than those treated with immunosuppressant alone. In our experience, IVIg as add-on treatment with CsA or MMF is useful in patients with myositis, even those with refractory or relapsed disease. We did not find any increase in the number or type of side effects.