Therapy of inflammatory myopathy.

The management of the muscular and extramuscular manifestations of the inflammatory myopathies remains a challenge for the practicing rheumatologist. Although corticosteroids remain the first line of therapy, their side effects often limit their usefulness. Paradoxically, one of the side effects of steroids, muscle weakness, is the very symptom at which therapy is aimed. Other immunosuppressive agents are of proven benefit alone or in combination with corticosteroids. The identification of characteristic autoantibodies that identify poor prognostic outcomes and the availability of newer immunosuppressive regimens should contribute to a more aggressive but perhaps safer therapeutic approach to the patient with myositis.