Dermatomyositis is a rare heterogeneous systemic
autoimmune disease with multiple organ involvement which can result in significant disability and mortality. Despite the lack of placebo-controlled trials,
glucocorticoids are considered to be the mainstay of initial management. Treatment strategies are mainly based on uncontrolled studies, evidence based guidelines for treatments do not exist. Areas covered: This review provides an overview of the currently available pharmacological treatments in the field of
dermatomyositis including conventional
immunosuppressants, biologics and topical agents. The role of
antibodies in different treatment responses of
dermatomyositis related clinicoserological syndromes is also discussed. A PubMed search was performed in order to find relevant literature for this review. Expert commentary: Early recognition and intervention is essential to ameliorate disease outcome. Determination of
antibodies provide a useful key in diagnosis, clinical manifestations,
malignancy, prognosis, and treatment response and may lead to wider acceptance of
personalized medicine.
Corticosteroids with adjunctive
steroid-sparing immunosuppressive therapies are recommended to treat disease activity, prevent mortality, and reduce long-term disability. Combinations of second-line
therapies or newer third-line
therapies are used in severe, refractory, or
corticosteroid-dependent diseases. Further research is required to assess the role of new
therapies.