Which medications in the drug class Immunosuppressants are used in the treatment of Polymyositis?

Updated: Feb 12, 2018
  • Author: Mythili Seetharaman, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Immunosuppressants

These agents may be of benefit in patients whose condition has not responded to steroids or in patients unable to tolerate prednisone.

Methotrexate (Rheumatrex, Trexall)

Methotrexate has an unknown mechanism of action in the treatment of chronic inflammatory diseases. It may affect immune function, including through inhibition of the production of proinflammatory cytokines. Methotrexate ameliorates symptoms of inflammation (eg, pain, swelling, stiffness). Adjust the dose gradually to attain a satisfactory response.

Azathioprine (Imuran, Azasan)

Azathioprine is a purine analog that inhibits the synthesis of deoxyribonucleic acid (DNA), RNA, and proteins. It may decrease the proliferation of immune cells, resulting in lower immunologic activity.

IV Immunoglobulin (Privigen, Hizentra, Octogam, Gammagard)

IVIG neutralizes circulating myelin antibodies through anti-idiotypic antibodies. It down-regulates proinflammatory cytokines, including interferon gamma; blocks Fc receptors on macrophages; suppresses helper T and B lymphocytes; and augments suppressor T lymphocytes. IVIG's exact mechanism of action in the treatment of polymyositis is unknown.

Chlorambucil (Leukeran)

Chlorambucil alkylates and cross-links strands of DNA, inhibiting DNA replication and RNA transcription.

Cyclophosphamide

Cyclophosphamide is chemically related to nitrogen mustards. As an alkylating agent, the mechanism of action of the active metabolites may involve cross-linking of DNA, which may interfere with the growth of normal cells such as lymphocytes and neoplastic cells.

Cyclosporine (Sandimmune, Neoral, Gengraf)

Cyclosporine is a cyclic polypeptide that suppresses cell-mediated immune reactions such as delayed hypersensitivity and, to a lesser extent, humoral immunity, allograft rejection, experimental allergic encephalomyelitis, and graft versus host disease for a variety of organs. Cyclosporine selectively inhibits the transcription of interleukin 2, predominantly in helper lymphocytes.

Mycophenolate (CellCept, MMF, Myfortic)

Inhibits T- and B-cell proliferation, as well as antibody production


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