improvement in muscle strength and 8). One retrospective chart review and two case neuromuscular symptoms of patients in series tried IVIg as add on therapy (Class III the intervention group (n=8). evidence). Taken together, 82% improved clinically in these studies. NAM: Patients with NAM were likely to have IBM: The Biotext (2004) review included previously been regarded as having PM, increasingly small controlled studies, two of this is being recognised as a separate entity. which had a crossover design. A total series consistently report improvement with sample of 77 patients diagnosed with immunosuppressive therapy. Often multiple IBM was followed for between 4 and 12 immunotherapeutic agents are required. High-dose months. The three studies showed steroids are the mainstay of therapy, with IVIg possible slight benefit in reducing required for some months as rescue therapy in endomysial inflammation, disease some patients, until other immunosuppressive progression and severity of IBM. agents become effective. No trials of IVIg or Further research is needed. prospective series have been conducted in NAM. Further research is needed. One submission reported the effectiveness of IVIg therapy for PM and DM as add-on therapy for patients who have not responded to steroids and immunosuppression (NSW IVIg User Group). A further submission confirms a role for IVIg as add-on maintenance therapy in some patients resulting in an increased
improvement in muscle strength and neuromuscular symptoms of patients in the intervention group (n=8). IBM: The Biotext (2004) review included small controlled studies, two of which had a crossover design. A total sample of 77 patients diagnosed with IBM was followed for between 4 and 12 months. The three studies showed possible slight benefit in reducing endomysial inflammation, disease progression and severity of IBM. Further research is needed. One submission reported the effectiveness of IVIg therapy for PM and DM as add-on therapy for patients who have not responded to steroids and immunosuppression (NSW IVIg User Group). A further submission confirms a role for IVIg as add-on maintenance therapy in some patients resulting in an increased 8). One retrospective chart review and two case series tried IVIg as add on therapy (Class III evidence). Taken together, 82% improved clinically in these studies. NAM: Patients with NAM were likely to have previously been regarded as having PM, increasingly this is being recognised as a separate entity. series consistently report improvement with immunosuppressive therapy. Often multiple immunotherapeutic agents are required. High-dose steroids are the mainstay of therapy, with IVIg required for some months as rescue therapy in some patients, until other immunosuppressive agents become effective. No trials of IVIg or prospective series have been conducted in NAM. Further research is needed.