Villalba L, Adams E M
National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Arthritis and Rheumatism Branch, Bethesda, MD 20892-1820, USA.
Curr Opin Rheumatol. 1996 Nov;8(6):544-51. doi: 10.1097/00002281-199611000-00008.
Evaluation of new therapies for the inflammatory myopathies is complicated by the heterogeneity of these syndromes as well as by the lack of internationally accepted definitions of disease categories and assessments of disease activity and chronicity. This review covers our opinion of therapies and emphasizes the need for an early rehabilitation evaluation for these patients. Oral corticosteroids are the first line of therapy for the inflammatory myopathies, but because of their side effects and the existence of a subset of patients in whom disease is controlled only with high-dose corticosteroids, we recommend considering the early use of a second-line immunomodulating agents or pulse intravenous methylprednisolone. A stepwise progression of therapies is suggested for patients who have increasing muscle weakness resulting from active disease.
炎症性肌病新疗法的评估因这些综合征的异质性以及缺乏国际公认的疾病分类定义和疾病活动及慢性程度评估而变得复杂。本综述涵盖了我们对治疗方法的看法，并强调了对这些患者进行早期康复评估的必要性。口服皮质类固醇是炎症性肌病的一线治疗药物，但由于其副作用以及存在仅需高剂量皮质类固醇才能控制疾病的部分患者，我们建议考虑早期使用二线免疫调节药物或静脉注射甲基强的松龙冲击治疗。对于因活动性疾病导致肌肉无力加重的患者，建议采用逐步递进的治疗方法。
