Experience with cyclophosphamide in the treatment of a young woman with refractory dermatomyositis

• Main Authors: Bambang Setiyohadi, R Sinto
• Format: Article
• Language: English
• Published: Indonesia Rheumatology Association 2018-02-01
• Series: Indonesian Journal of Rheumatology
• Online Access: https://journalrheumatology.or.id/index.php/ijr/article/view/43

Dermatomyositis is an idiopathic inflammatory myopathy characterized by the presence of rash and moderate-to-severe muscle weakness secondary to inflammation of the muscle. It can be a difficult condition to treat. Systemic corticosteroids are the first choice of treatment. However, about a quarter of patients either fail to respond to steroids or develop steroid-related toxicity. Second-line agents such as azathioprine and methotrexate are then added either alone, or in combination with corticosteroids. Failure of the disease to respond to second-line agents can then be a problem and this is often referred to as “refractory dermatomyositisâ€. Unfortunately, there is neither agreement nor wellestablished guidelines on the best regimen or combination of immunosuppressive agents in the case of refractory dermatomyositis.