Therapy | Myositis

Therapy

The treatment of dermatomyositis and polymyositis corresponds to the mostly applied therapy of autoimmune diseases. Cortisone is administered, which partially inhibits the immune system and leads to a flattening of the inflammation, so that the tissue can recover. Relatively high doses are used, which are gradually reduced over a longer period of time.

Depending on the patient, the effect sets in after days to weeks, in delayed cases after 1-2 months. However, long-term cortisone administration is associated with a variety of side effects, such as muscle loss, osteoporosis or psychological changes. If the therapy does not have the desired effect or if the dosage must be reduced due to side effects, additional cytostatic drugs such as methotrexate can be used, which also have a firm place in tumor treatment and additionally compress the immune system. The administration of high-dose immunoglobulins can be helpful in polymyositis and dermatomyositis, but is particularly controversial in the treatment of inclusion body myositis. In addition to drug therapy, physiotherapy and occupational therapy can be used to maintain freedom of movement and prevent muscle shortening (contractions).In the case of pronounced muscle weakness, the use of walking aids or wheelchairs, in the case of paralysis, hardening of muscles or injuries, further treatment may be necessary.

Prognosis

With regular therapy, half of the patients with polymyositis can be completely cured. Otherwise, a standstill with more or less permanent muscle weakness can be achieved. However, in 20 % of the cases there is the possibility that no success can be achieved despite extensive therapy.

Dermatomyositis can also be cured or at least limited by appropriate therapy. The treatment of the tumor diseases that often cause the disease can cause a permanent improvement of the symptoms or a healing of the secondary disease. Since drug therapy of an inclusion body myositis is not promising, a constant level of movement must be achieved through physiotherapy and independent exercises.

Even light strength exercises and muscle endurance training can counteract the symptoms. If the throat musculature is affected, a visit to a speech therapist can provide relief to improve swallowing difficulties. Helpful movements or postures are practiced to facilitate the swallowing process.