What management strategies should I implement for a patient diagnosed with inflammatory myopathy?

Management of inflammatory myopathy should begin with prompt initiation of immunosuppressive therapy, primarily high-dose corticosteroids, to control muscle inflammation and improve strength. This is the cornerstone of treatment and should be started as early as possible to prevent irreversible muscle damage. ¹ (Sevim et al., 2024) Adjunctive immunosuppressive agents such as methotrexate or azathioprine are commonly introduced early to allow corticosteroid tapering and reduce long-term steroid toxicity. ¹ (Guo et al., 2024) In cases of refractory or severe disease, intravenous immunoglobulin (IVIG) or biologic therapies like rituximab may be considered, especially in immune-mediated necrotizing myopathy or dermatomyositis with systemic involvement. (Suh and Amato, 2024) (Sevim et al., 2024)

Supportive management includes physical therapy to maintain muscle function and prevent contractures, alongside monitoring and managing extramuscular manifestations such as interstitial lung disease or malignancy screening, which are important in certain subtypes. ¹ (Guo et al., 2024) Regular assessment of muscle enzymes, strength, and functional status guides treatment adjustments. (Suh and Amato, 2024)

Overall, a multidisciplinary approach involving rheumatology, neurology, physiotherapy, and sometimes dermatology or respiratory specialists is essential for optimal outcomes. ¹ (Sevim et al., 2024) Emerging therapies and tailored pharmacological strategies are under investigation, but current management remains centred on immunosuppression combined with supportive care. (Guo et al., 2024)