Inclusion-Body Myositis (IBM)

Medical Management

Treatment with drugs that suppress the immune system has been tried in inclusion-body myositis (IBM) but in general has not been effective. Some physicians may try corticosteroids or other medications that alter the immune response if a patient wishes to receive this treatment. However, many clinicians feel that side effects outweigh any subtle benefits that might occur with immunosuppressant drugs, especially for patients with other autoimmune disease.

Patients with dysphagia (difficulty swallowing) should be evaluated by a speech therapist. It is essential to teach IBM patients techniques to minimize the risk of aspiration. Exercise is likely beneficial for patients and is highly recommended after careful evaluation of a physiotherapist. Aerobic and muscle strengthening programs have proven to be beneficial.^1,2,3

IBM is generally a slowly progressing disease, and life expectancy is not significantly affected. Most people with IBM remain able to walk, although they may require a cane or wheelchair for long distances. Some are more profoundly affected, becoming gradually more disabled and needing wheelchairs full-time within 10 or 15 years of their first symptoms.

References

1. Johnson, L. G. et al. Improvement in aerobic capacity after an exercise program in sporadic inclusion body myositis. J. Clin. Neuromuscul. Dis. (2009). doi:10.1097/CND.0b013e3181a23c86
2. Alexanderson, H. & Lundberg, I. E. Exercise as a therapeutic modality in patients with idiopathic inflammatory myopathies. Current Opinion in Rheumatology (2012). doi:10.1097/BOR.0b013e32834f19f5
3. Spector, S. A. et al. Safety and efficacy of strength training in patients with sporadic inclusion body myositis. Muscle and Nerve (1997). doi:10.1002/(SICI)1097-4598(199710)20:10<1242::AID-MUS6>3.0.CO;2-C