Efficacy of immunosuppression in adults diagnosed with inclusion body myositis

Date of Award

Winter 2021

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Shannon Diallo

Abstract

Introduction: Sporadic Inclusion Body Myositis is considered the most common muscle disorder in patients older than 50 years old with rates as high as 15 per million. The disease typically presents as proximal muscle wasting with difficulty standing, sitting, and walking up and down stairs. The disease falls under a category of diseases called idiopathic inflammatory myopathies which include dermatomyositis, polymyositis, and immune-mediated necrotizing myopathy. In these related diseases patients respond well to immunosuppression. However, inclusion body myositis has been found to be resistant to similar treatments.

Methods: In November 2019 three literature searches were performed on PubMed, EBSCO, Google scholar. The articles were then reviewed based on relevance to the research question, quality of research, and research type.

Results: Based on the results Alemtuzumab shows the most promise of effective immunosuppression treatment. Various other treatments were found to not be effective, cause too much of an adverse reaction, or subjectively not benefit the patient enough to warrant the objective improvement noted.

Discussion: To establish a new treatment guideline the strongest of data must be presented. Many articles present conflicting information that is further compounded by the evaluation of objective vs subjective amelioration.

Conclusion: Though current research won’t dictate clinical practice it does produce future avenues of research. Those future avenues are evaluating objective vs subjective effectiveness of immunosuppression, Alemtuzumab, immunohistological emphasis of treatment, and immunosuppression in comorbid autoimmune diseases.

Comments

Recording link passcode: Hy8E&%

Additional Files

References.docx (13 kB)
Capstone Poster Presentation.pptx (1000 kB)
Capstone Abstract.docx (12 kB)

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Efficacy of immunosuppression in adults diagnosed with inclusion body myositis

Introduction: Sporadic Inclusion Body Myositis is considered the most common muscle disorder in patients older than 50 years old with rates as high as 15 per million. The disease typically presents as proximal muscle wasting with difficulty standing, sitting, and walking up and down stairs. The disease falls under a category of diseases called idiopathic inflammatory myopathies which include dermatomyositis, polymyositis, and immune-mediated necrotizing myopathy. In these related diseases patients respond well to immunosuppression. However, inclusion body myositis has been found to be resistant to similar treatments.

Methods: In November 2019 three literature searches were performed on PubMed, EBSCO, Google scholar. The articles were then reviewed based on relevance to the research question, quality of research, and research type.

Results: Based on the results Alemtuzumab shows the most promise of effective immunosuppression treatment. Various other treatments were found to not be effective, cause too much of an adverse reaction, or subjectively not benefit the patient enough to warrant the objective improvement noted.

Discussion: To establish a new treatment guideline the strongest of data must be presented. Many articles present conflicting information that is further compounded by the evaluation of objective vs subjective amelioration.

Conclusion: Though current research won’t dictate clinical practice it does produce future avenues of research. Those future avenues are evaluating objective vs subjective effectiveness of immunosuppression, Alemtuzumab, immunohistological emphasis of treatment, and immunosuppression in comorbid autoimmune diseases.