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What are current treatments for Dermatomyositis?


What are current treatments for Dermatomyositis?

There is only treatment available at this time- there is no cure. Treatment consists of corticosteriods, immunosuppressants, antimalarial medications, intravenous immunoglobulin, physical therapy, surgery, and over the counter pain relievers. Other treatments that can be done include plasmapheresis and radiation, but no one knows what type of long term effects these may have. There are some other treatments, but they are still in the experimental stage. These include a topical medication and a medication that would usually be used as a transplant rejection drug.

From the "National Institute of Neurological Disorders and Stroke"

"Prescribing a steroid drug, such as prednisone, is usually the first line of treatment. Immunosuppressants, such as azathioprine and methotrexate, may help those for whom prednisone is ineffective. Further treatment with intravenous immunoglobulin was shown to be effective and safe. Physical therapy is usually recommended to preserve muscle function and prevent muscle wasting. "

Steroid therapy is the mainstay - like prednisolone. Cytotoxic drugs like methotrexate or azathioprine are also used. Immune glogulin therapy has also been tried.

Dapsone is used for the skin lesions.

Although there's no cure for dermatomyositis, treatment can improve your skin, muscle strength and function. Treatment begun early in the disease process tends to be more effective, often because there are fewer complications. Methods of therapy include the following:

Corticosteroids. These medications suppress your immune system, limiting the production of antibodies and reducing skin and muscle inflammation. Corticosteroids, especially prednisone, are usually the first choice in treating inflammatory myopathies such as dermatomyositis. Your doctor may start with a very high dose, and then decrease it as your signs and symptoms improve. This generally takes about two to four weeks. Your doctor may also prescribe topical corticosteroids for your skin. Visible results are usually evident within three to six months, but therapy is often needed for years. Prolonged use of corticosteroids can have serious side effects including osteoporosis, weight gain, diabetes, increased risk of someinfections, mood swings, cataracts, high blood pressure, a redistribution of body fat and muscle weakness. As a result, your doctor may also recommend supplements such as calcium and vitamin D and may prescribe bisphosphonates such as alendronate (Fosamax) or risedronate (Actonel).

Immunosuppressants. If your body doesn't respond adequately to corticosteroids, your doctor may recommend other immunosuppressive drugs such as azathioprine (Imuran) or methotrexate (Rheumatrex). Your doctor may prescribe these alone or in combination with corticosteroids. When in combination, these additional immunosuppressants can be used to lessen the dose and potential side effects of the corticosteroid. Immunosuppressants such as cyclophosphamide (Cytoxan) and cyclosporine (Neoral, Sandimmune) may improve signs and symptoms of dermatomyositis and interstitial lung disease.

Antimalarial medications. For a persistent rash, your doctor may prescribe an antimalarial medication such as hydroxychloroquine (Plaquenil) or chloroquine phosphate (Aralen). Be aware, however, that adverse reactions to such medications, though uncommon, can be confused with the rash or weakness of dermatomyositis itself.

Intravenous immunoglobulin (IVIg). This involves receiving intravenous infusions of antibodies from a group of donors over two to five days. This treatment is still under investigation and is usually expensive. It may be an option for you if your dermatomyositis is severe or resistant to other forms of therapy.

Physical therapy. A physical therapist can show you various exercises to maintain and improve your strength and flexibility and advise an appropriate level of activity. Your exercise program is likely to change during the course of the disease and treatment period. Keeping active in general and pacing yourself will help maintain muscle strength.

Surgery. Surgery may be an option to remove painful calcium deposits.

Pain relievers. Over-the-counter drugs such as aspirin, ibuprofen (Advil, Motrin, others) and acetaminophen (Tylenol, others), can be used to treat any accompanying pain. If these aren't sufficient, your doctor may prescribe a stronger pain reliever, such as codeine.

Treatments with unknown long-term effects include:

Plasmapheresis. This treatment, also called plasma exchange, is a type of blood cleansing in which damaging antibodies are removed from your blood.

Radiation therapy. This involves irradiation of the lymph nodes to suppress your immune system.

Hope this helps :)

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