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Tacrolimus-Induced Remission in Drug Resistant Inflammatory Myopathy: A Case Series

Karina Rotella, Milena Rodriguez Alvarez, Yair Saperstein, Manjeet S. Bhamra, Su Zhaz Leon, Alekznder Feoktiztov and Isabel MFarlane

Idiopathic inflammatory myopathies are rare autoimmune disorders characterized by proximal muscle weakness, elevation of muscle enzymes, abnormal electromyogram and imaging studies revealing areas of edema and inflammation. Initial approach to inflammatory myopathies includes steroids and immunosuppressive agents, with most individuals responding satisfactorily to therapy. However, treatment-refractory myopathies prompts clinicians to use second line agents to achieve remission. In this case series, we describe three patients with refractory idiopathic inflammatory myopathies who were treated with tacrolimus (TAC) added to mycophenolate mofetil (MMF) and steroid therapy, who achieved clinical and biochemical remission.