Juvenile dermatomyositis also has a few novel specificities, particularly anti-p140, which is found in 25% of these patients, Dr. Gunawardena said. “Unlike adults, autoantibodies against Jo-1 are rarely seen in juvenile dermatomyositis.”
Dr. Gunawardena concluded that adapting a serological approach to dermatomyositis would be helpful.
Promoting Physical Activity
In the final presentation of the symposium, Ingrid E. Lundberg, MD, PhD, professor in the rheumatology unit at the Karolinska Institutet of the Karolinska University Hopsital in Stockholm, Sweden, focused on the value of physical activity for patients with inflammatory myopathy.
Lack of physical activity is major health problem recognized by the World Health Organization and is a risk factor for cardiovascular disease and death, she said. This is important for patients with an inflammatory myopathy because they are already at a greater risk for cardiovascular problems. Dr. Lundberg shared data from a 2008 study of physical activity in rheumatoid arthritis patients that found that the majority of patients were physically inactive. However, there was a wide variation among patients from the different countries included in the study, with patients from some countries more active than others.3 Dr. Lundberg is not aware of a similar study done with myositis patients. However, she did say that myositis patients have reduced aerobic fitness and that previous work has shown that myositis patients have significantly lower maximum oxygen uptake than controls.4 Maximum oxygen uptake is associated with aerobic endurance. “One question is whether by improved fitness we can change the rate of cardiovascular death in myositis,” she said.
Although it is common to think that exercise may worsen muscle inflammation in myositis patients, Dr. Lundberg was inspired to test the role of exercise by a few patients who were eager to show their physical strength.
Although it is common to think that exercise may worsen muscle inflammation in myositis patients, Dr. Lundberg said she was “inspired to test the role of exercise” by a few patients who were eager to show their physical strength. In a 1999 study, she and fellow researchers performed a pilot study with 10 patients who were treated with low doses of immunosuppressives and were still relatively weak. The program included 15 minutes of muscle work followed by 15 minutes of walking or cycling for five days a week over a 12-week period.5 Researchers did not see any signs of increased inflammation in these patients and found improvement in muscle function in all patients.
