Patient no. | Previously failed IS | Concomitant IS | Baseline prednisone dose | Key clinical feature |
All | 2.6 (1.1) IS failed+all failed pred | Mean (SD): 2.4 (0.8) Pred: 11; MTX: 5; AZA: 3; TAC: 1; MMF: 5; HCQZ: 2 | Mean (SD) dose: 19.5 (15.3) | Severe muscle weakness: 8 (one dropped out at week 6) Moderate-severe DM rash: 5 |
1 | Pred (30 months, 60 mg taper), MTX (30 months, 15 mg), MMF (15 months, 2 g) | Pred, MTX (15 mg), MMF (2 g) | 7.5 mg | Moderate-severe rashes and mild muscle weakness |
2 | Pred (>12 months, 60 mg taper), TAC (39 months, 4 mg), AZA (unknown, 200 mg), MMF (unknown, 2 g), MTX (4 months, 15 mg) | Pred, HCQZ (400 mg) | 20 mg | Moderate-severe rashes, no muscle weakness |
3 | Pred (17 months, 60 mg taper), MTX (16 months, 20 mg), AZA (14 months, 100 mg) | Pred, AZA (100 mg), MTX (15 mg) | 42.5 mg | Severe muscle weakness |
4 | Pred (14 months, 80 mg taper), MTX (14 months, 25 mg), MMF (2 months, 2 g), AZA (6 months, 100 mg) | Pred, AZA (100 mg), MMF (2 g) | 10 mg | Severe muscle weakness |
5 | Pred (11 months, 60 mg taper), MTX (5 months, 20 mg), MMF (3 months, 3 g), AZA (3 months, 100 mg) | Pred, AZA (100 mg), MMF (3 g) | 50 mg | Moderate-severe rashes and severe muscle weakness |
6 | Pred (15 months, 60 mg taper), TAC (3 months, 3 mg), AZA (3 months, 100 mg), MMF (5 months, 3 g), MTX (9 months, 25 mg) | Pred, TAC (3 mg) | 7.5 mg | Severe rashes and mild muscle weakness |
7 | Pred (18 months, 60 mg taper), IVIG (6 months), MMF (7 months, 3 g), MTX (18 months, 22.5 mg) | Pred, MTX (22.5 mg), MMF (3 g), HCQZ (400) | 10 mg | Moderate-severe rashes and severe muscle weakness |
8 | Pred (24 months, 40 mg taper), MTX (8 months, 17.5 mg) | Pred, MTX (17.5 mg) | 2.5 mg | Severe muscle weakness; dysphagia |
9 | Pred (24 months, 60 mg taper), IVIG (8 months, 2 g/kg), rituximab (12 months ago, 2 g), MTX (18 months, unknown) | Pred | 20 mg | Severe muscle weakness; dysphagia |
10 | Pred (6 months, 60 mg taper), MTX (5 months, 25 mg) | Pred, MTX | 15 mg | Severe muscle weakness; mild arthritis |
11 | Pred (8 months, 50 mg taper), IVIG (8 months, 1 g/kg), MMF (5 months, 3 g) | Pred, MMF (3 g) | 30 mg | Severe muscle weakness |
All medication doses are daily doses except MTX which is weekly.
*Muscle enzymes are represented as times the upper limit of normal of the most abnormal enzyme (ie, CK, aldolase, LDH, AST, ALT) at baseline.
AA, African–American; ALT, alanine transaminase; AST, aspartate transaminase; AZA, azathioprine; DK, creatine kinase; DM, dermatomyositis; HCQZ, hydroxychloroquine; IS, immunosuppression; IVIG, intravenous immunoglobulin; LDH, lactate dehydrogenase; MMF, mycophenolate; MMT, Manual Muscle Testing; MTX, methotrexate; NM, necrotising myopathy; PM, polymyositis; pred, prednisone; TAC, tacrolimus; VAS, Visual Analogue Scale.