Polymyositis is an uncommon disease that causes
inflammation in your muscles. Doctors also refer to
it as a type of connective tissue disease. Its most
noticeable characteristic is muscle weakness,
especially in the muscles closest to your trunk,
such as your shoulder and hip muscles. As a result,
you may find it difficult to get out of chairs,
climb stairs, brush your hair or work with your arms
over your head. The disease is rarely fatal, but it
can be disabling in its more severe forms.
Although there's no cure for polymyositis, treatment can improve your
muscle strength and function. Treatment begun early in the disease
process tends to be more effective, often because there are fewer
complications. Methods of therapy include the following:
These medications suppress your immune system, limiting the
production of antibodies and reducing muscle inflammation.
Corticosteroids, especially prednisone (Deltasone), are usually the
first choice in treating inflammatory myopathies such as
polymyositis. Your doctor may begin with a very high dose, then
decrease it as your symptoms improve. This generally takes about two
to four weeks. Significant results are usually evident within three
to six months, but therapy is often needed for years. Prolonged use
of corticosteroids can have serious side effects including
osteoporosis, weight gain, diabetes, increased risk of some
infections, mood swings, cataracts, high blood pressure, a
redistribution of body fat and muscle weakness. As a result, your
doctor may also recommend supplements such as calcium and vitamin D
and may prescribe bisphosphonates such as alendronate (Fosamax) or
risedronate (Actonel). If you're postmenopausal, your doctor may
prescribe estrogen to reduce the risk of osteoporosis.
If your body doesn't respond adequately to corticosteroids, your
doctor may recommend other immunosuppressive drugs such as
azathioprine (Imuran) or methotrexate (Folex, Rheumatrex). Your
doctor may prescribe these alone or in combination with
corticosteroids. When in combination, these additional
immunosuppressants can be used to lessen the dose and potential side
effects of the corticosteroid. Immunosuppressants such as
cyclophosphamide (Cytoxan, Neosar) and cyclosporine (Neoral,
Sandimmune) may improve symptoms of polymyositis and interstitial
A physical therapist can show you various exercises to maintain and
improve your strength and flexibility and advise an appropriate
level of activity. Your exercise program is likely to change during
the course of the disease and treatment period. Keeping active in
general and pacing yourself will help maintain muscle strength.
Treatments whose long-term effectiveness isn't known include:
This involves receiving intravenous infusions of antibodies from a
group of donors over two to five days.
This treatment, also called plasma exchange, is a type of blood
cleansing in which damaging antibodies are removed from your blood.
Therapeutic plasmapheresis is a process in which the fluid part of the
blood, called plasma, is removed from blood cells by a device known as a
cell separator. ...
Treatments that are still in the experimental phase but have shown signs
of being effective include fludarabine (Fludara), an agent that prevents
the development and growth of malignant cells, and tacrolimus (Prograf),
a transplant rejection drug.
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