J Korean Med Sci.  2003 Feb;18(1):131-134. 10.3346/jkms.2003.18.1.131.

Successful Combination Therapy of Cyclosporine and Methotrexate for Refractory Polymyositis with Anti-Jo-1 Antibody: A Case Report

• Chang HK
• Lee DH

• KMID: 1099810
• DOI: http://doi.org/10.3346/jkms.2003.18.1.131

Abstract

Although corticosteroids have been the initial agent for the treatment of inflammatory myopathies (IM), immunosuppressive agents such as azathioprine, methotrexate, cyclophosphamide, or cyclosporine are commonly required to control the disease except mild cases. On the other hand, the efficacy of combination therapy of cyclosporine and methotrexate in severe rheumatoid arthritis has been proven without serious side effects. However, in treatment-resistant myositis, the experience of such a therapy is very limited, and has not been described in refractory polymyositis with anti-Jo-1 antibody. Here, we report a young female patient with recalcitrant polymyositis and anti-Jo-1 antibody who was successfully treated with the combination therapy of cyclosporine and methotrexate. At first, the myositis did not respond to several agents, such as corticosteroid, monthly pulse cyclophosphamide, azathioprine, or cyclosporine. Methotrexate was initially avoided as treatment regimen because of its potential pulmonary toxicity in the case with preexisting lung disease.

Keyword

Polymyositis; Anti-Jo-1 Antibody; Cyclosporine; Methotrexate

MeSH Terms

Adult
Antibodies, Antinuclear/blood*
Autoantigens/immunology
Cyclosporine/administration & dosage
Cyclosporine/therapeutic use*
Drug Resistance
Drug Therapy, Combination
Female
Histidine-tRNA Ligase/immunology
Human
Immunosuppressive Agents/administration & dosage
Immunosuppressive Agents/therapeutic use*
Methotrexate/administration & dosage
Methotrexate/therapeutic use*
Polymyositis/drug therapy*
Polymyositis/immunology