FDA approval bolsters options for myositis management

Inflammatory myositis can often be managed, but management options can change depending on which organ system is involved as well as the specific symptoms patients are experiencing. For example, patients with anti-synthetase syndrome and interstitial lung disease may benefit from a multimodal approach that includes immunosuppressive therapy, physical therapy, and pulmonary rehabilitation.

“The biggest update in the treatment landscape of myositis is the U.S. Food and Drug Administration (FDA) approval of intravenous immunoglobulin (IVIG) for dermatomyositis in July 2021,” said Julie Jisun Paik, MD, MHS, Director of Clinical Trials, Johns Hopkins Myositis Center, and Associate Professor of Medicine, Johns Hopkins Medicine.

IVIG has been used off label to manage dermatomyositis since the 1990s, she noted, but FDA approval is a clinical game changer for rheumatologists and their patients. Dr. Paik will discuss the clinical implications of IVIG as an approved agent in the treatment of dermatomyositis during the 2022 CARE session Clinical Pearls: Myositis on Saturday, November 12, from 11–11:45 p.m. ET. Karen Yanelli, PT, DPT, Cert. MDT, will focus on physical and pulmonary rehabilitation in the management of different forms of myositis.

Registered ACR Convergence attendees can join the session in person in Terrace Ballroom II and III of the Pennsylvania Convention Center or on the meeting website via livestream, or view the session on demand.

IVIG is likely the first of many new treatment options for myositis.

“There is a plethora of clinical trials that are on the horizon in myositis,” Dr. Paik said.

She recently led an investigator-initiated pilot study of tofacitinib, a Janus kinase (JAK) inhibitor, that confirmed significant improvement in skin predominant refractory dermatomyositis. There are now ongoing Phase 2 studies internationally evaluating JAK inhibitors in myositis. There is also a Phase 3 trial of a combination JAK/TYK (tyrosine kinase) inhibitor that is scheduled to be launched early next year.

In addition to discussing updates in the treatment of myositis, Dr. Paik will highlight key clinical autoantibody associations in myositis. Attendees can expect a specific focus on new developments in the literature in the past year.