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Elephant in the room
  1. Daniel M Hartung1,
  2. Kirbee Johnston1,
  3. David M Cohen2,
  4. Thuan Nguyen3,
  5. Atul A Deodhar4,
  6. Dennis N Bourdette5,6
  1. 1 College of Pharmacy, Oregon State University/Oregon Health & Science University, Corvallis, Oregon, USA
  2. 2 Department of Medicine, Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA
  3. 3 School of Public Health, Oregon Health & Science University, Corvallis, Oregon, USA
  4. 4 Division of Arthritis & Rheumatic Diseases, Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
  5. 5 Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
  6. 6 MS Center of Excellence–West, VA Portland Health Care System, Portland, Oregon, USA
  1. Correspondence to Dr Atul A Deodhar, Department of Medicine, Division of Arthritis & Rheumatic Diseases, Oregon Health & Science University, Portland, Oregon OR 97239-3098, USA; deodhara{at}ohsu.edu

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We read with interest the article by Aggarwal et al on repository corticotropin injection (RCI) in the treatment of refractory polymyositis and dermatomyositis (PM and DM) published in the Annals of the Rheumatic Diseases.1

The authors, who are well-respected researchers in the field of myositis, have done a good job in conducting a small open-label trial of RCI in the treatment of PM/DM using validated disease activity measures and outcome measures. Whether these patients were truly ‘resistant’ is debatable, since only 3 of the 11 patients were treated with intravenous immunoglobulin (IVIG) …

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