Traitement de la polymyosite chez l'adulte de 18 ans et plus

References

DOI: 10.1093/rheumatology/keac115

• High dose glucocorticoids should be used to treat active muscle inflammation at time of treatment induction.
• Oral prednisolone at a dose of 0.5–1 mg/kg/day, usually 40–60 mg, is recommended.
• Intravenous methylprednisolone is to be considered, especially when there are concerns about gastrointestinal absorption.
• Oral prednisolone should be tapered according to clinical response.
• Disease modifying anti-rheumatic drugs should be used to reduce muscle inflammation, achieve clinical remission and reduce steroid burden.
• Methotrexate, azathioprine, tacrolimus, ciclosporin, and mycophenolate mofetil are to be considered for the treatment of active myositis and long-term maintenance of disease remission.
• Management of IIM should include a safe and appropriate exercise programme led and monitored by a specialist physiotherapist and/or a specialist occupational therapist to improve quality of life and function.
• Glucocorticoid dose should be weaned when disease activity, considered across all domains, substantially improves, usually after around 6 weeks of treatment initiation.