Efficacy and safety of the combined treatment with intravenous immunoglobulin and oral glucocorticoid in the elderly with dermatomyositis / 中华老年医学杂志

ABSTRACT

Objective To explore the efficacy and safety of intravenous immunoglobulin and glucocorticoid treatment in elderly dermatomyositis patients. Methods Sixty elderly patients with dermatomyositis were randomly divided into two groups prednisone alone (n= 30, PA) (first 1 mg per kilogram of body weight daily,then decrease the dose according to disease activity), and the combined treatment (n=30,CT,first 1 mg per kilogram of body weight daily, then decrease the dose according to disease activity, and intravenous immunoglobulin 0. 4 g per kilogram of body weight per month for three months). The improvement of clinical symptoms and the occurrence of side effects were observed at the end of month 3. Results The time of muscle strength recovery, remittences of myasthenia and myalgia visual analogue scale(VAS), the decreasing rates of creatine phospho kinase (CPK) level and the dose of prednisone at the end of month 3 were superior in CT group versus PA group (P<0. 05), while no significant differences in the improvement of rash, muscle strength,erythrocyte sedimentation rate(ESR),C-reactive protein (CRP) and side effects between two groups.Conclusions Combination with intravenous immunoglobulin and oral glucocorticoid is a safe and effective treatment for elderly patients with dermatomyositis, it can alleviate symptoms quickly,decrease CPK level and prednisone dose significantly.