Use of methotrexate in inflammatory myopathies

The inflammatory myopathies are a heterogeneous group of diseases including dermatomyositis, polymyositis, and inclusion body myositis. Few clinical trials have been reported in myositis, it is difficult to make definitive recommendations for the treatment of these potentially life threatening diseases. In addition to treatment with corticosteroids, immunosuppressive agents and immunomodulatory therapy are used to improve disease control and reduce the long-term side effects of corticosteroids. While these treatments are commonly used in routine clinical practice, the optimal therapeutic regimen remains unclear. However, most patients with dermatomyositis or polymyositis are treated with oral high-dose prednisone combined with azathioprine or methotrexate to facilitate tapering of prednisone.