What to do ... When the treatment does not work: Polymyositis
Mastaglia, F.L. (2008) What to do ... When the treatment does not work: Polymyositis. Postgraduate Medical Journal, 84 (993). pp. 382-384.
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Although patients with polymyositis or dermatomyositis may respond to treatment with corticosteroids alone, in many cases a combination of steroids and an immunosuppressive agent is required to achieve satisfactory disease control and remission.1 However, about 20–30% of patients with polymyositis, and a similar proportion of cases of dermatomyositis and overlap syndromes, have persisting weakness and raised serum creatine kinase (CK) activity, or continue to deteriorate. In such cases it is necessary to review the clinical and muscle biopsy findings on which the diagnosis of an inflammatory myopathy had been based, and whether the treatment administered had been appropriate, and consider other treatment options. In addition, if they have not already been done, investigations should be performed to exclude an underlying malignancy and other contributory causes of muscle weakness and raised serum CK activity, such as thyroid and other endocrine conditions and drug-induced disorders...
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