Corticosteroid-sparing effect of tacrolimus in the initial treatment of dermatomyositis and polymyositis

Modern Rheumatology
Yusuke YokoyamaHiroshi Nakajima

Abstract

In the treatment of polymyositis (PM) and dermatomyositis (DM), muscle inflammation and underlying autoimmunity need to be suppressed promptly; however, catabolic effects of corticosteroids such as myopathy can be detrimental in PM/DM. In this study, we aimed to assess the corticosteroid-sparing effect of tacrolimus in the initial treatment of PM/DM. We retrospectively identified 19 PM/DM patients who received initial treatment with prednisolone at an initial dose of 1 mg/kg/day (Conventional Monotherapy, our standard therapy before 2008) and 23 patients with tacrolimus plus prednisolone at an initial dose 0.8 mg/kg/day (Tacrolimus Combination, our standard therapy after 2008). Data until 36 months after commencing treatment were collected. There were no statistically significant differences in baseline characteristics between two groups. Median daily dose of prednisolone in the Tacrolimus Combination Group was significantly lower than that in the Conventional Monotherapy Group during the study period, whereas the proportion of patients who required additional immunosuppressive medications for remission induction was comparable. Remission was achieved in all patients, except one who died of refractory interstitial lung disease ...Continue Reading

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Citations

Jul 28, 2016·International Journal of Rheumatic Diseases·Ken-Ichi UenoShu-Ichi Ikeda
Apr 11, 2018·Current Rheumatology Reports·Christopher A Mecoli, Lisa Christopher-Stine
Apr 20, 2018·Modern Rheumatology·Hirokazu Sasaki, Hitoshi Kohsaka
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Aug 6, 2016·Therapeutic Advances in Musculoskeletal Disease·James LillekerRobert Cooper
Sep 2, 2019·Current Rheumatology Reports·Kristen L ChenVictoria P Werth
Jan 8, 2019·Current Treatment Options in Rheumatology·Simone Barsotti, Ingrid E Lundberg

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