The following is a summary of “Efficacy and safety of repository corticotropin injection for refractory cutaneous dermatomyositis: a prospective, open-label study,” published in the November 2023 issue of Rheumatology by Fernandez et al.
Repository corticotropin injection (RCI) is an FDA-approved treatment for DM, but its efficacy and safety for cutaneous dermatomyositis (DM) are not well-known. Researchers performed a prospective study to assess the efficacy and safety of RCI in treating refractory cutaneous DM.
The study included diabetic patients with moderate-to-severe skin symptoms [Cutaneous Dermatomyositis Disease Area and Severity Index activity (CDASI-A)] despite prior treatment with at least two systemic agents. These patients were given 80 units of RCI twice weekly for six months. The primary outcomes assessed were substantial reductions in CDASI-A and Physician’s Global Assessment (PGA) scores after six months of treatment.
About 19 patients were initially enrolled, with 15 patients (11 females, 4 males) having diabetes mellitus (DM) (7 classic, 8 amyopathic)– completing six months of RCI treatment. Before enrollment, these patients had received a median of 3.0 systemic medications and were on a median of 2.0 systemic medications. The baseline CDASI-A score was 19.0, the PGA activity score was 2.5/10, the PtGSS score was 3.0/10, and the dermatology life quality index(DLQI) score was 7.0/10. At 6 months, significant improvements were observed in CDASI-A scores (median = 10.0), PGA scores (median = 0.8/10), PtGSS scores (median = 7.0), and DLQI scores (median = 2.0), among other outcomes. Adverse effects were mild.
The study found that RCI treatment was an effective, safe, and well-tolerated treatment for refractory cutaneous dermatomyositis, significantly improving skin disease activity and QoL.
