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Topics:
Rheumatology • Myositis • Dermatomyositis • Neurology • Dermatology • Neuromuscular • Systemic autoimmune diseases • RheumMadness
How will you sequence therapies in dermatomyositis given the results of the ProDERM trial?
Will you still favor starting with steroids and traditional immunosuppressive agents, move IVIG earlier in your treatment strategy, or start with IVIG instead of traditional immunosuppressives?
This question is part of a collaboration with RheumMadness and is specifically in reference to: PRODERM
Answer from: at Academic Institution
I will try oral immunosuppressants first, either methotrexate, azathioprine, or mycophenolate first; and then add IVIG if there is no response or even minimal response.
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Answer from: at Academic Institution
The landmark ProDerm trial rigorously showed the benefits of IVIG for dermatomyositis but (just as importantly) provided us with incredibly valuable information about the rates/degree of response to IVIG and quantitative information about the safety of the medication.This data is key for both develo...
Comments
at Emory Health
First of all Prateek, you ARE expert opinion. I v...
First of all Prateek, you ARE expert opinion. I v...
Answer from: at Community Practice
The benefits of IVIG in dermatomyositis treatment have been well established (Dalakas et al., PMID 8247075), and further validated in the PRODERM trial. In my personal experience, patients with dermatomyositis and significant muscle involvement rarely respond to steroids and/or oral immunomodulatory...