Idiopathic Inflammatory myopathy (IIM) Includes Dermatomyositis and Polymyositis *does not include Inclusion Body Myositis (IBM)

Recommendations:

IVIG is indicated in patients with IIM as adjunctive therapy to corticosteroids and/or a steroid sparing agent in patients with IIM who have failed 1st line therapy or as clinically indicated in the management of severe disease.

*IVIG benefit has not been established in IBM.

1st line: Corticosteroids and Methotrexate and/or Azathioprine

2nd line: IVIG

3rd line: Cyclosporine or cellcept

 

 

Dose:

Maximum dose is 2 g/kg to be given over 2 days initially monthly for 3-6 months and if effective to be continued at decreasing frequency (determine minimum effective dose) over approximately 2 years.

Survival of patients with IIM has been shown to be substantially improved in patients given IVIG.