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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. 1College of Pharmacy, Oregon State University/Oregon Health & Science University, Corvallis, Oregon, USA
  2. 2Department of Medicine, Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA
  3. 3School of Public Health, Oregon Health & Science University, Corvallis, Oregon, USA
  4. 4Division of Arthritis & Rheumatic Diseases, Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
  5. 5Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
  6. 6MS 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}

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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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  • Contributors All authors contributed to the content of the article, edited the content and gave permission to submit.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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