Recent and ongoing research continues to increase understanding of the underlying mechanisms of myositis, providing important groundwork for the development of new diagnostic and screening tools and novel therapies and treatment approaches.
An expert panel will review the latest information about diagnosing and managing inflammatory myositis during the session, Updates in Myositis, which will take place from 4:30 – 6:00 pm Monday in the Thomas Murphy Ballroom, Building B of the Georgia World Congress Center. Gregory Gardner, MD, Gilliland-Henderson Professor of Medicine in the Division of Rheumatology at the University of Washington, will lead off the session with a review of the EULAR/ACR myositis classification criteria and an overview of current forms of idiopathic inflammatory myopathies.
“It’s important to remember that the diagnostic criteria we use in the clinic are different than the classification criteria, which are really designed to help researchers put people into groupings for studies and clinical trials,” Dr. Gardner said. “As clinicians, we may need to take a broader approach, meaning sometimes we have to take into account variables that aren’t included in the classification criteria. People with antisynthetase syndrome, for example, are not included as a classification subset in the criteria as they currently stand.”
The recent discovery of new myositis-specific antibodies, he said, is changing the way clinicians think about myositis, in terms of both the clinical manifestations and prognosis, and have led to the development of new screening and diagnostic testing tools.
“In addition to new laboratory tests, there are also imaging tests that we can use, particularly MRI scanning, to help us guide our diagnostic evaluation of people with idiopathic inflammation myositis,” Dr. Gardner said.
In a subsequent presentation, Rohit Aggarwal, MD, MS, will review strategies to risk stratify myositis patients for appropriate malignancy screening and discuss the sensitivity and specificity of malignancy testing in patients with myositis. Dr. Aggarwal is an Associate Professor of Medicine, Rheumatology and Clinical Immunology, Medical Director of the Arthritis and Autoimmunity Center and Co-Director of the Myositis Center at the University of Pittsburgh.
“This is an extremely important topic because, for a long time, it has been a bit of a struggle knowing whom to screen and what type of cancer screening to do,” Dr. Aggarwal said. “This is particularly important for dermatomyositis because there is a high association of underlying malignancies in these patients, more so than with polymyositis or necrotizing myopathy.”
He said that significant advances over the past decade, including the identification of new myositis-specific antibodies, are helping clinicians identify patients who are at highest risk of having or developing an underlying malignancy when they develop dermatomyositis.
“This has led to a huge change and a shift in how we approach these patients,” Dr. Aggarwal said. “Previously, we thought that we needed to do age-appropriate cancer screening for all dermatomyositis and polymyositis patients. We can do much better risk stratification and more or less aggressive cancer screening based on the associated risk.”
Lisa Christopher-Stine, MD, MPH, Associate Professor of Medicine and Neurology at Johns Hopkins University School of Medicine and Co-Founder and Director of the Johns Hopkins Myositis Center, will review potential treatments for inflammatory myositis, discuss the results of recent clinical trials and describe the current recommendations for therapy based on patient clinical presentation and biomarkers.