Although glucocorticoids and other immunosuppressive agents can be used to treat myositis, response remains variable and often disappointing. Disease related mortality is about 10%. Most patients die from cancer and/or treatment complications, while survivors often remain disabled [2. Bronner, I. M., M. F. van der Meulen, et al., 2006].
To date there is limited information on prognostic markers that could help in decision making for treatment. Furthermore, given the limited effectiveness of available therapeutic agents in myositis, new treatments are clearly required. To date clinical trials have been limited due to the rarity of the disease and lack of validated outcome measures. Moreover, to facilitate the use and development of novel therapies, the aetiopathogenic mechanisms underlying myositis require further elucidation.
Exercise in myositis
Accumulated evidence indicate that resistance exercise might reduce muscle inflammation in adult chronic polymyositis and dermatomyositis [20. Alexanderson H and Lundberg IE, 2012]. These data support safety and efficacy of exercise in polymyositis and dermatomyositis, although data are more inconclusive for efficacy in patients with IBM. There is a need for larger studies to further ensure efficacy in IBM and juvenile dermatomyositis .
Exercise is believed to have added value when carried out in combination with conventional immunosuppressive treatment, and it shows particular promise in patients with chronic stable disease with low inflammatory disease activity. However, we also need to understand about effects of exercise in active, recent-onset disease.
The recommendation is supervised, moderate exercise with varying movements to avoid overuse of any muscles, in combination with immunosuppressive drugs .