Corticosteroids in Myositis and Scleroderma

Rheum Dis Clin North Am. 2016 Feb;42(1):103-18, ix. doi: 10.1016/j.rdc.2015.08.011. Epub 2015 Oct 26.

Abstract

Idiopathic inflammatory myopathies (IIMs) involve inflammation of the muscles and are classified by the patterns of presentation and immunohistopathologic features on skin and muscle biopsy into 4 categories: dermatomyositis, polymyositis, inclusion body myositis, and immune-mediated necrotizing myopathy. Systemic corticosteroid (CS) treatment is the standard of care for IIM with muscle and organ involvement. The extracutaneous features of systemic sclerosis are frequently treated with CS; however, high doses have been associated with scleroderma renal crisis in high-risk patients. Although CS can be effective first-line agents, their significant side effect profile encourages concomitant treatment with other immunosuppressive medications to enable timely tapering.

Keywords: Corticosteroids; Glucocorticoids; Idiopathic inflammatory myopathies; Morphea; Myositis; Scleroderma; Systemic sclerosis.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Biopsy
  • Dermatomyositis / diagnosis
  • Dermatomyositis / drug therapy
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Muscle, Skeletal / pathology
  • Myositis / diagnosis
  • Myositis / drug therapy*
  • Myositis, Inclusion Body / diagnosis
  • Myositis, Inclusion Body / drug therapy
  • Polymyositis / diagnosis
  • Polymyositis / drug therapy
  • Scleroderma, Systemic / diagnosis
  • Scleroderma, Systemic / drug therapy*
  • Skin / pathology

Substances

  • Adrenal Cortex Hormones
  • Glucocorticoids
  • Immunosuppressive Agents