Here again, the target antigens have been recently precised (respectively TIF1-γ and MDA5) [13], ELISA have been developed, leading to think that routine test will soon be available. All these efforts for the development of immunological or pathological tools and finally for a better classification of the myositides are aimed to define homogeneous groups of patients, receiving appropriate treatments. It is now accepted that conventional immunosuppressants (corticosteroids, methotrexate, azathioprine, intravenous immunoglobulins…) have no (or transient and
modest) effects on muscle strength during IBM. It is then extremely important to distinguish this condition from PM, to avoid useless (and potentially dangerous) treatments. Nevertheless, DAPT research buy the debate is still open LY2157299 solubility dmso concerning the primum movens of IBM: is it an immunological [5] or a degenerative [4] phenomenon? The development of future therapeutic strategies (and trials) will thus depend of the investigator’s convictions: unconventional immunosuppressant
and/or modulator (such as certain biotherapies) in one hand or anti-amyloid (such as in Alzheimer disease) on the other. Nonetheless, for the other more easily treatable myositides, one may be surprised, in 2011, by the weakness of evidence-based medicine [14] and the lack of recommendations. It is also surprising that in most of the studies, PM, DM, overlap syndrome with muscle inflammation or IMNM are indistinguishably treated in the same manner [14], despite their different physiopathogenesis. This is presumably due to the rarity of these diseases, and the lack of worldwide, concerted effort
to date. However, things are undisputedly changing, as preclinical models are now mature [3], that will help for the choice of the molecules to be tested. Efforts are made to set up and standardize diagnostic criteria and to define outcomes for the future clinical trials, not only in PM/DM/IMNM [7] but also in IBM [15] and [16] and other international workshops are planned. Furthermore, big pharmaceutical companies are developing biotherapies potentially targeted for myositides and their interest for these diseases L-NAME HCl seems to progress. We can thus be quite enthusiastic: no doubt that all these efforts will allow, in the near future, to start multicentric, prospective, randomised trials for the benefit of the patients. none “
“Inflammatory or necrotizing myopathies, myositides and other acquired myopathies, new insight in 2011. O. Benveniste et al., Paris, France Observations on the classification of the inflammatory myopathies D. Hilton-Jones, Oxford, United Kingdom Pathogenic aspects of dermatomyositis, polymyositis and overlap myositis R.K.