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Review
. 2020 Jan;61(1):5-16.
doi: 10.1002/mus.26708. Epub 2019 Nov 4.

Immunosuppressive and immunomodulatory therapies for neuromuscular diseases. Part I: Traditional agents

Constantine Farmakidis  1 , Mazen M Dimachkie  1 , Mamatha Pasnoor  1 , Richard J Barohn  1
Affiliations
Review

Immunosuppressive and immunomodulatory therapies for neuromuscular diseases. Part I: Traditional agents

Constantine Farmakidis et al. Muscle Nerve. 2020 Jan.

Abstract

Immunosuppressive and immunomodulatory therapies have had a major effect on the treatment of immune-mediated neuromuscular diseases. After the landmark introduction of synthetic corticosteroids, other therapies have become available, including plasma exchange (PLEX), immunoglobulin G (IgG), and steroid-sparing immunosuppressive drugs. More recently, novel biologically derived and antigen-specific pharmaceuticals have entered neuromuscular practice. Various levels of evidence guide the use of these treatments. This article reviews current immune-based therapies in neuromuscular diseases and is divided into two parts. Part I provides an update on the evidence and use of traditional therapies, such as corticosteroids, PLEX, intravenously delivered IgG (IVIG), and steroid-sparing immunosuppressive drugs. Part II focuses on the recently US Food and Drug Administration-approved therapies eculizumab and subcutaneous IgG (SCIG), the current indications for rituximab in neuromuscular disease, and on novel immunosuppressive therapeutic approaches under development.

Keywords: IVIG; azathioprine; corticosteroids; methotrexate; neuromuscular diseases; plasma exchange.

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References

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