Abstract
The idiopathic inflammatory myopathies embody the largest group of acquired and potentially treatable causes of skeletal muscle weakness. The three major groups of this disorder are polymyositis (PM), dermatomyositis (DM), and inclusion body myositis. Corticosteroids continue to be the mainstay of initial treatment in the majority of cases of PM/DM. The treatment of refractory disease can be challenging despite the utilization of the medications currently available. We report two patients with refractory DM who were treated with infliximab. We describe their presentation, clinical course, treatment, and outcomes.
This is a preview of subscription content, log in via an institution to check access.
References
Bohan A, Peter JB (1975) Polymyositis and dermatomyositis. N Engl J Med 292:344–347, 403–407
Marie I, Hachulla E, Hatran PY et al (2001) Polymyositis and dermatomyositis: short term and long term outcome, and predictive factors of prognosis. J Rheumatol 28:2230–2237
Airio A, Kautiainen H, Hakala M (2006) Prognosis and mortality of polymyositis and dermatomyositis patients. Clin Rheumatol 25:234–239
Choy EH, Isenberg DA (2002) Treatment of dermatomyositis and polymyositis. Rheumatology (Oxford) 41:7–13
Agarwal SK, Monach PA, Docken WP, Coblyn JS (2005) Characterization of relapses in adult idiopathic inflammatory myopathies. Clin Rheumatol 24:1–6
Takada K, Nagasaka K, Miyasaka N (2005) Polymyositis/dermatomyositis and interstitial lung disease: a new therapeutic approach with T-cell-specific immunosuppressants. Autoimmunity 38:383–392
Levine TD (2005) Rituximab in the treatment of dermatomyositis: an open label study. Arthritis Rheum 52:601–607
Edge JC, Outland JD, Dempsey JR, Callen JP (2006) Mycophenolate mofetil as an effective corticosteroid-sparing therapy for recalcitrant dermatomyositis. Arch Dermatol 142:65–69
Oryoji K, Himaji D, Nagafuji K et al (2005) Successful treatment of rapidly progressive interstitial pneumonia with autologous peripheral blood stem cell transplantation in a patient with dermatomyositis. Clin Rheumatol 24:637–640
Korkmaz C, Tamiz C, Cetinbas F, Buyukkidan B (2004) Successful treatment of alveolar hypoventilation due to dermatomyositis with anti-tumor necrosis factor-alpha. Rheumatology (Oxford) 43:937–938
Anandacoomarasamy A, Howe G, Manolios N (2005) Advanced refractory polymyositis responding to infliximab. Rheumatology 44:562–563
Keystone EC (2004) The utility of tumor necrosis factor blockade in orphan diseases. Ann Rheum Dis 63(Suppl 2):ii79–ii83
Kuru S, Inukai A, Liang Y, Doyu M, Takano A, Sobue G (2000) Tumor necrosis factor-alpha expression in muscles of polymyositis and dermatomyositis. Acta Neuropathol 99:585–588
Shimizu T, Tomita Y, Son K, Nishinarita S, Sawada S, Horie T (2000) Elevation of serum soluble tumor necrosis factor receptor in patients with polymyositis and dermatomyositis. Clin Rheumatol 19:352–359
Pachman LM, Liotta-Davis MR, Hong DK et al (2000) TNFalpha-308A allele in juvenile dermatomyositis: association with increased production of tumor necrosis factor alpha, disease duration, and pathologic calcifications. Arthritis Rheum 43:2368–2377
Hengstman GJD, van den Hoogen FHJ, Barrera P, Netea MG, Pieterse A, van den Pute LBA et al (2003) Successful treatment of dermatomyositis and polymyositis with anti-tumor necrosis factor-alpha: Preliminary observations. Eur Neurol 50:10–15
Hengstman GJD, van den Hoogen FHJ, van Engelen BGM (2004) Treatment of dermatomyositis and polymyositis with anti-tumor necrosis factor-alpha: long-term follow-up. Eur Neurol 52:61–63
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dold, S., Justiniano, M.E., Marquez, J. et al. Treatment of early and refractory dermatomyositis with infliximab: a report of two cases. Clin Rheumatol 26, 1186–1188 (2007). https://doi.org/10.1007/s10067-006-0325-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-006-0325-z