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Effect of early treatment in polymyositis and dermatomyositis
Peyman Naji1, Farhad Shahram, Abdolhadi Nadji
1Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Background:
Idiopathic inflammatory myopathies, dermatomyositis (DM) and polymyositis (PM) are rare but are potentially treatable.
Aim:
To compare the effect of early and late treatment in patients with PM and DM.
Materials And Methods:
The study included all the adult patients with definite diagnosis of PM or DM treated for at least 12 months. The patients were divided into two groups: Early Group - treatment within three months and Late Group - treatment after three months. The number of patients with positive therapeutic response, remission in less than one year and the mean time elapsed for reaching the remission were assessed and compared between the two groups. Chi-square test, Fisher's exact test, t-test and Pearson correlation test were used for data analysis.
Results:
The analysis included 65 patients, 42 with DM and 23 with PM. Late Group included 24 patients (seven PM and 17 DM), while Early Group included 41 patients (16 PM and 25 DM). Positive therapeutic response, remission rate within one year was higher in Early Group (80% vs. 46%, P: 0.004). The mean time needed to achieve remission was much less with early treatment (5.5 vs. 11.9 months, P: 0.003). The relapse rate was also lower in Early Group (5% vs. 25%, P < 0.02). The comparison of treatment outcomes showed the same results in both PM and DM, but it was statistically significant in patients with DM.
Conclusions:
Early treatment in patients with PM and DM is associated with higher remission rates, shorter treatment period and low complication rates.
Insights
Early treatment for polymyositis (PM) and dermatomyositis (DM) leads to better outcomes. Patients receiving prompt therapy experience higher remission rates and shorter recovery times.
Area of Science:
- Rheumatology
- Immunology
- Neurology
Background:
- Idiopathic inflammatory myopathies, including dermatomyositis (DM) and polymyositis (PM), are rare conditions.
- Despite their rarity, DM and PM are treatable conditions.
Purpose of the Study:
- To compare the efficacy of early versus late treatment initiation in patients diagnosed with polymyositis (PM) and dermatomyositis (DM).
Main Methods:
- Adult patients with a definitive diagnosis of PM or DM, treated for at least 12 months, were analyzed.
- Patients were categorized into an Early Group (treatment within 3 months) and a Late Group (treatment after 3 months).
- Outcomes assessed included positive therapeutic response, remission rates within one year, and mean time to remission, with statistical analysis using Chi-square, Fisher's exact, t-test, and Pearson correlation.
Main Results:
- The study analyzed 65 patients (42 DM, 23 PM), with 41 in the Early Group and 24 in the Late Group.
- The Early Group demonstrated significantly higher remission rates within one year (80% vs. 46%, P=0.004) and a shorter mean time to remission (5.5 vs. 11.9 months, P=0.003).
- Relapse rates were lower in the Early Group (5% vs. 25%, P<0.02), with statistically significant benefits observed in DM patients.
Conclusions:
- Initiating treatment early for polymyositis (PM) and dermatomyositis (DM) is linked to improved clinical outcomes.
- Early intervention is associated with higher remission rates and a reduced duration of treatment.
- Prompt treatment also correlates with lower complication rates in patients with PM and DM.
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