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Adv Rheumatol ; 59: 6, 2019. tab, graf
Article Dans Anglais | LILACS | ID: biblio-1088584

Résumé

Abstract Background: Recommendations of the Myopathy Committee of the Brazilian Society of Rheumatology for the management and therapy of systemic autoimmune myopathies (SAM). Main body: The review of the literature was done in the search for the Medline (PubMed), Embase and Cochrane databases including studies published until June 2018. The Prisma was used for the systematic review and the articles were evaluated according to the levels of Oxford evidence. Ten recommendations were developed addressing the management and therapy of systemic autoimmune myopathies. Conclusions: Robust data to guide the therapeutic process are scarce. Although not proven effective in controlled clinical trials, glucocorticoid represents first-line drugs in the treatment of SAM. Intravenous immunoglobulin is considered in induction for refractory cases of SAM or when immunosuppressive drugs are contra-indicated. Consideration should be given to the early introduction of immunosuppressive drugs. There is no specific period determined for the suspension of glucocorticoid and immunosuppressive drugs when individually evaluating patients with SAM. A key component for treatment in an early rehabilitation program is the inclusion of strengthbuilding and aerobic exercises, in addition to a rigorous evaluation of these activities for remission of disease and the education of the patient and his/her caregivers.


Sujets)
Adulte , Humains , Maladies auto-immunes/traitement médicamenteux , Glucocorticoïdes/usage thérapeutique , Immunosuppresseurs/usage thérapeutique , Maladies musculaires/traitement médicamenteux , Rhumatologie , Sociétés médicales , Maladies auto-immunes/rééducation et réadaptation , Brésil , Méthylprednisolone/administration et posologie , Méthylprednisolone/effets indésirables , Prednisone/administration et posologie , Prednisone/effets indésirables , Marqueurs biologiques/sang , Exercice physique , Essais contrôlés randomisés comme sujet , Éducation du patient comme sujet , Immunoglobulines par voie veineuse/usage thérapeutique , Polymyosite/thérapie , Dermatomyosite/thérapie , Traitement par les exercices physiques , Rituximab/usage thérapeutique , Glucocorticoïdes/effets indésirables , Immunosuppresseurs/effets indésirables , Maladies musculaires/rééducation et réadaptation
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