Polimiositis y dermatomiositis refractaria en adultos: Opciones terapéuticas
Palabras clave:
Dermatomiositis, Polimiositis, Terapéutica, Acciones farmacológicas, MiositisResumen
La dermatomiositis y polimiositis son enfermedades autoinmunes raras, clasificadas dentro de las miopatías inflamatorias, y caracterizadas clínicamente por debilidad muscular, frecuentemente acompañada de manifestaciones extramusculares. Los pacientes usualmente logran la remisión o niveles bajos de actividad de la enfermedad con el tratamiento inicial con glucocorticoides (pueden o no estar asociados a inmunomoduladores), cuando este falla se considera una dermatomiositis y polimiositis refractarias (antes se debe realizar una nueva biopsia muscular para descartar diagnósticos alternativos) por lo cual se requerirán tratamientos adicionales para su manejo. El tratamiento de la dermatomiositis y polimiositis refractarias continúa siendo un reto debido a la falta de evidencia científica que permita validar la efectividad de fármacos alternativos. Esta revisión presenta algunas de las alternativas terapéuticas. Se encontró en la literatura como prometedoras para disminuir la morbimortalidad en ambas patologías las terapias biológicas, especialmente el rituximab y abatacept.
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