Abstract

In an attempt to find a better way to treat steroid-resistant myositis (other than inclusion body myositis), we have carried out a randomized crossover trial of intravenous methotrexate with leukovorin rescue and a combination of methotrexate and azathioprine. Accrual of patients is about two-thirds complete. We have carried out two extensive retrospective analyses of the therapy of myositis. One, of well over 100 patients on whom thorough records of responses were available, was analyzed for the factors that influence the responses to prednisione, methotrexate, and azathioprine. The other was a close analysis of the responses to steroid and cytotoxic therapy in almost 30 patients with inclusion body myositis, including an analysis of the first ever controlled therapeutic trial in that condition which we carried out over the past several years. These have now been published.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Intramural Research (Z01)
Project #
1Z01AR041076-06
Application #
3770186
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
6
Fiscal Year
1993
Total Cost
Indirect Cost

  Institution

Name
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Department
Type
DUNS #
City
State
Country
United States
Zip Code

  Publications

Alger, Heather M; Raben, Nina; Pistilli, Emidio et al. (2011) The role of TRAIL in mediating autophagy in myositis skeletal muscle: a potential nonimmune mechanism of muscle damage. Arthritis Rheum 63:3448-57
Nagaraju, Kanneboyina; Rawat, Rashmi; Veszelovszky, Edina et al. (2008) Dysferlin deficiency enhances monocyte phagocytosis: a model for the inflammatory onset of limb-girdle muscular dystrophy 2B. Am J Pathol 172:774-85
O'Hanlon, Terrance P; Carrick, Danielle Mercatante; Targoff, Ira N et al. (2006) Immunogenetic risk and protective factors for the idiopathic inflammatory myopathies: distinct HLA-A, -B, -Cw, -DRB1, and -DQA1 allelic profiles distinguish European American patients with different myositis autoantibodies. Medicine (Baltimore) 85:111-27
Sarkar, Kakali; Weinberg, Clarice R; Oddis, Chester V et al. (2005) Seasonal influence on the onset of idiopathic inflammatory myopathies in serologically defined groups. Arthritis Rheum 52:2433-8
O'Hanlon, Terrance P; Carrick, Danielle Mercatante; Arnett, Frank C et al. (2005) Immunogenetic risk and protective factors for the idiopathic inflammatory myopathies: distinct HLA-A, -B, -Cw, -DRB1 and -DQA1 allelic profiles and motifs define clinicopathologic groups in caucasians. Medicine (Baltimore) 84:338-49
Christopher-Stine, Lisa; Plotz, Paul H (2004) Myositis: an update on pathogenesis. Curr Opin Rheumatol 16:700-6
Christopher-Stine, Lisa; Plotz, Paul H (2004) Adult inflammatory myopathies. Best Pract Res Clin Rheumatol 18:331-44
Plotz, P (2004) The place of autoimmunity in myositis. Autoimmun Rev 3 Suppl 1:S36
Isenberg, D A; Allen, E; Farewell, V et al. (2004) International consensus outcome measures for patients with idiopathic inflammatory myopathies. Development and initial validation of myositis activity and damage indices in patients with adult onset disease. Rheumatology (Oxford) 43:49-54
Miller, F W; Rider, L G; Plotz, P H et al. (2004) Polymyositis: an overdiagnosed entity. Neurology 63:402; author reply 403