Dermatomyositis: Drug Therapy

Therapy goals

• Symptom relief
• Immunosuppression (drug suppression of the immune system).

Therapy recommendations

• Local treatment
  • Symptomatic local corticosteroids (as ointment).
  • Removal of calcinosis lesions
• Systemic treatment
  • Central treatment with glucocorticoids: Prednisolone; possibly higher initial dose in the first 4 weeks.
    • Cave: fluorinated glucocorticoids such as dexamethasone and triamcinolone can cause myopathies (muscle pain) and should be avoided!
    • Due to long-term treatment, if necessary, substitution of calcium and vitamin D.
  • In case of therapy resistance combination with immunosuppressants: azathioprine or also methotrexate, (also immunoglobulins i. v. are possible).
  • If even then no improvement occurs: rituximab (monoclonal antibody).
• Systemic treatment of juvenile dermatomyositis (JDM).
  • Combination of prednisone and methotrexate (first-line standard therapy).
  • If necessary, also prednisone plus ciclosporin (cyclosporin A).