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Treating refractory dermatomyositis or polymyositis with adrenocorticotropic hormone gel: a retrospective case series

Authors Levine T

Received 19 April 2012

Accepted for publication 16 May 2012

Published 11 June 2012 Volume 2012:6 Pages 133—139


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Todd Levine

Phoenix Neurological Associates, Phoenix, AZ, USA

Background: Effective and tolerable treatment options for patients with dermatomyositis and polymyositis are limited. This retrospective case review describes treatment with adrenocorticotropic hormone (ACTH) gel in five patients who experienced a disease exacerbation and either failed or were unable to tolerate the side effects of previous therapy with steroids, intravenous immunoglobulins, and steroid-sparing drugs.
Methods: Patients received ACTH gel subcutaneous injections of 80 U (1 mL) twice weekly (four patients) or once weekly (one patient) over the course of 12 weeks for short-term treatment of symptom exacerbations. Manual muscle testing using the Medical Research Council scale was assessed at baseline and at 3 months.
Results: Improvement was seen in all patients, including improved muscle strength, decreased pain, and resolution of skin involvement. All patients tolerated the treatment well, and no significant side effects occurred.
Conclusion: The treatment of dermatomyositis and polymyositis is an approved use for ACTH gel, and these anecdotal reports would suggest consideration of ACTH gel as a therapeutic option. Further investigation is warranted.

Keywords: adrenocorticotropic hormone gel, dermatomyositis, polymyositis, steroids, intravenous immunoglobulins

Erratum for this paper has been published.

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