Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China.
Dermatol Ther. 2021 Jul;34(4):e14976. doi: 10.1111/dth.14976. Epub 2021 May 25.
Anti-TNF treatment may be useful for patients with idiopathic inflammatory myopathies (IIMs). The purpose of this study is to assess the efficacy of infliximab (IFX) in the management of IIMs. Two databases (ie, PubMed and China National Knowledge Infrastructure) were searched up to Nov 2020 for studies investigating skin lesions and muscular weakness in patients with IIMs treated with IFX. A total of 18 studies were included. One hundred and eighteen patients were identified, including 58 adult patients and 60 patients with juvenile dermatomyositis (JDM) treated with IFX. Among these patients, 110 (93%) patients with refractory cases. In addition to glucocorticoids, patients from 15/18 studies received immunosuppressant agents (ISAs) concomitantly with IFX, among which methotrexate (MTX) was most common. After treatment with IFX, skin lesions and muscle strength were improved in 67% of patients with DM and 75% of patients with JDM, respectively. Skin calcinosis was improved in 21/34 (62%) of patients with JDM. Only 55% (12/22) of patients with polymyositis exhibited improvements in muscle strength. Lastly, 40% (42/104) of patients reported adverse events. Current evidence appears to support the use of IFX in some patients with refractory IIMs, especially those with JDM. The most common adverse reaction was infection. Large, randomized-controlled studies should be carried out to confirm these findings.
抗 TNF 治疗可能对特发性炎性肌病（IIM）患者有用。本研究旨在评估英夫利昔单抗（IFX）在 IIM 治疗中的疗效。截至 2020 年 11 月，我们检索了两个数据库（即 PubMed 和中国国家知识基础设施），以调查用 IFX 治疗的 IIM 患者的皮肤病变和肌肉无力的研究。共纳入 18 项研究。共确定了 118 例患者，包括 58 例成人患者和 60 例幼年皮肌炎（JDM）患者接受 IFX 治疗。这些患者中，110 例（93%）为难治性病例。除了糖皮质激素外，15/18 项研究的患者同时接受免疫抑制剂（ISAs）与 IFX 联合治疗，其中最常见的是甲氨蝶呤（MTX）。用 IFX 治疗后，分别有 67%的 DM 患者和 75%的 JDM 患者的皮肤病变和肌肉力量得到改善。34 例 JDM 患者中有 21 例（62%）的皮肤钙质沉着症得到改善。仅 55%（12/22）的多发性肌炎患者的肌肉力量有所改善。最后，有 40%（42/104）的患者报告了不良反应。目前的证据似乎支持在一些难治性 IIM 患者中使用 IFX，特别是那些 JDM 患者。最常见的不良反应是感染。应开展大型、随机对照研究以证实这些发现。
