Idiopathic inflammatory myopathy: management and prognosis

The treatment of the idiopathic inflammatory myopathies is challenging. Patient heterogeneity, limited clinical trial data, and suboptimal assessment tools to quantitate disease activity and damage and reliably distinguish between them, contribute to the therapeutic challenges that clinicians face. Despite these limitations and challenges, a therapeutic plan should be developed and followed. Rehabilitative measures and physical therapy interventions should be included at every stage in the treatment plan. Although corticosteroids remain the mainstay of an initial treatment plan, combination immunosuppressive regimens and other novel disease-modifying immunologic agents are new additions to the therapeutic arsenal of inflammatory myopathy. Systemic complications, particularly interstitial lung disease, continue to significantly contribute to the morbidity and mortality of the myositis syndromes, and comprehensive management approaches must address the muscular and extramuscular features of these disorders.