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Utility of Myositis-Specific Autoantibodies for Treatment Selection in Myositis

  • Other CTD: Inflammatory Myopathies and Sjogren's (I Pinal-Fernández, Section Editor)
  • Published:
Current Treatment Options in Rheumatology Aims and scope Submit manuscript

Abstract

Purpose of Review

Autoimmune myopathies (IMs) are a group of diseases characterized by muscle weakness and inflammatory infiltrates on the muscle biopsy. `However, muscle involvement is not always present and other organs and tissues (lung, skin, and joints) are commonly affected. The most accepted classification for IM includes dermatomyositis, sporadic inclusion body myositis, immune-mediated necrotizing myopathy, polymyositis, and overlap myositis. Seventy percent of the autoantibodies that IM patients have are myositis-specific autoantibodies (MSAs). Importantly, MSAs are associated with specific clinical phenotypes in IM patients. The therapy of IMs consists of glucocorticoids, immunosuppressants, biologic, and immunomodulatory drugs, but there is recent evidence that patients with some types of MSAs respond better to certain treatments. The purpose of this review is to summarize the IM treatment from an autoantibody perspective.

Recent Findings

Each MSA is maybe associated with the activation of specific pathogenic pathways which can be effectively targeted by specific drugs. The last few years have shown multiple examples of successful treatments for each MSA group of patients as we will describe in the following paragraphs.

Summary

The adverse effects of the IM therapeutic agents and some patients’ refractoriness call for a continued search for better and more targeted therapies. MSA groups should be considered for a treatment decision.

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Authors and Affiliations

  1. Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 50 South Drive, Room 1141, Building 50, MSC 8024, Bethesda, MD, 20892, USA

    Maria Casal-Dominguez MD, PhD, Iago Pinal-Fernández MD, PhD & Andrew L Mammen MD, PhD

  2. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Maria Casal-Dominguez MD, PhD, Iago Pinal-Fernández MD, PhD & Andrew L Mammen MD, PhD

  3. Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain

    Iago Pinal-Fernández MD, PhD

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  1. Maria Casal-Dominguez MD, PhD
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Correspondence to Maria Casal-Dominguez MD, PhD.

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This article is part of the Topical Collection on Other CTD: Inflammatory Myopathies and Sjogren’s.

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Casal-Dominguez, M., Pinal-Fernández, I. & Mammen, A.L. Utility of Myositis-Specific Autoantibodies for Treatment Selection in Myositis. Curr Treat Options in Rheum 8, 105–116 (2022). https://doi.org/10.1007/s40674-022-00198-1

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