Myositis refers to a group of autoimmune diseases that cause chronic inflammation in the muscles, leading to muscle weakness, fatigue, and sometimes damage to other organs. These diseases can be debilitating, but recent advancements in medical research have led to new treatment options, offering hope to myositis patients. This blog post will explore signs and symptoms, who it affects, and new treatments for myositis, including emerging therapies and the role of neuroplasticity in managing myositis symptoms.
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What Is Myositis?
Myositis is a group of autoimmune diseases where the body’s immune system mistakenly attacks muscle tissue.
Symptoms of Myositis
The symptoms of myositis can vary depending on the specific type of the disease, but common signs include:
- Muscle weakness: Often starting in the muscles closest to the trunk, such as the shoulders, hips, and thighs.
- Fatigue: Persistent tiredness that does not improve with rest.
- Difficulty swallowing: A symptom of polymyositis and dermatomyositis, which can affect throat muscles.
- Skin rashes: Present in patients with dermatomyositis, where skin inflammation accompanies muscle weakness.
- Joint pain: In some cases, joint pain and swelling may occur.
- Breathing issues: Interstitial lung disease (ILD), a severe complication that affects lung tissue, can occur in some patients.¹
Symptoms can develop gradually over weeks or months, making early detection and treatment crucial for improving outcomes.
Who Does Myositis Affect?
Myositis can affect people of all ages, though certain forms are more common in specific populations:
- Inclusion Body Myositis (IBM): This condition primarily affects adults over 50, more commonly men, and is characterized by slow but progressive muscle weakness, particularly in the arms and legs.²
- Dermatomyositis (DM): This type can occur in adults and children. Adult dermatomyositis often affects women, while juvenile dermatomyositis is seen in children under 16 years old.
- Polymyositis (PM): Affects adults, particularly women, and is more likely to occur in people with other autoimmune diseases like rheumatoid arthritis.
- Immune-Mediated Necrotizing Myopathy (IMNM): A severe and rapidly progressive form of myositis that affects muscle strength and function.³
Myositis is rare, affecting approximately 5-10 people per million each year. Diagnosis typically requires a combination of clinical features, muscle biopsy, and manual muscle testing.⁴
New Treatments for Myositis
Brain Retraining and Neuroplasticity
Emerging research is exploring the potential of brain retraining and neuroplasticity to help manage myositis symptoms. Neuroplasticity refers to the brain’s ability to reorganize and form new neural connections, particularly in response to chronic pain, inflammation, and stress. Chronic muscle inflammation and fatigue in myositis can create maladaptive feedback loops in the brain, reinforcing pain and limiting muscle function.
Brain retraining techniques like mindfulness, cognitive behavioral therapy, and neurofeedback can help patients reduce stress and improve the brain-body connection, ultimately promoting muscle healing and reducing inflammation. Neuroplasticity-based interventions may also aid in regulating the immune response, reducing the activation of T cells and other immune cells that attack muscle tissue.¹⁰
Although research is still in its early stages, neuroplasticity represents an exciting avenue for treating chronic conditions like myositis. By retraining the brain to respond differently to inflammation and muscle fatigue, patients may experience improved muscle strength and a better quality of life.
Monoclonal Antibody Therapies
Monoclonal antibody (mAb) therapies are proving to be a significant advancement in the treatment of myositis, particularly for refractory patients—those who do not respond to traditional therapies. Rituximab, a mAb that targets B cells, has shown great promise for patients with dermatomyositis, polymyositis, and immune-mediated necrotizing myopathy (IMNM). A study published in Arthritis Rheumatology found that rituximab provided substantial clinical improvement in muscle function, inflammation reduction, and disease control for patients who had not responded to conventional treatments.⁵
A phase II trial demonstrated that rituximab was especially effective for patients with refractory inflammatory myopathies, reducing muscle inflammation and enhancing muscle strength.⁶
Intravenous Immune Globulin (IVIG)
Intravenous immune globulin (IVIG) therapy is another promising treatment option for myositis patients, especially those with severe or refractory myositis. IVIG works by modulating the immune system, mainly B cells and antigen-presenting cells, to reduce inflammation and protect muscle tissue. In a double-blind, placebo-controlled trial, patients receiving IVIG significantly improved muscle function and overall disease activity compared to those who received a placebo.⁷
T-Cell Modulation and Immune System Regulation
Myositis is driven by the body’s immune system, particularly T cells, attacking healthy muscle tissue. New treatments aim to modulate T-cell activation and promote immune regulation. One area of focus is the role of regulatory T cells (Tregs) in suppressing harmful immune responses. Early research has shown that enhancing Treg activity may reduce muscle inflammation and improve outcomes for refractory myositis patients.⁸
Addressing Myositis-Related Lung Disease
Complications such as interstitial lung disease (ILD) are common in myositis patients, particularly those with dermatomyositis or polymyositis. To reduce the progression of lung disease, new treatments targeting the immune pathways that contribute to lung inflammation, such as B-cell activating factor (BAFF) inhibitors, are being explored. These therapies aim to prevent further lung damage and improve the overall quality of life for patients with myositis-related ILD.⁹
Clinical Trials and Combination Therapies
Clinical trials play a crucial role in evaluating the effectiveness of new treatments for myositis. Recent clinical trials have tested combinations of conventional therapies, such as rituximab or IVIG, with new experimental treatments that modulate the immune system. These trials have shown promising results, particularly for refractory adult patients who have not responded well to traditional treatment methods.¹¹
Combination therapies that target both immune cells and muscle tissue show the potential to improve outcomes for patients with chronic inflammation. As more clinical data from these trials become available, we can expect further advancements in the personalized treatment of myositis.
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A Promising Future for Myositis Treatment
The treatment landscape for myositis is rapidly evolving, with new therapies offering hope to patients who have struggled with the disease for years. From monoclonal antibodies and IVIG to innovative approaches like brain retraining and neuroplasticity, these advancements are helping myositis patients improve their muscle strength, reduce inflammation, and achieve a better quality of life. As research continues, the future looks promising for those living with this challenging autoimmune disease.
The re-origin program is designed to help you learn to calm your nervous system, balance your immune system, and manage symptoms of chronic health conditions. If you’re ready to start your healing journey, learn more about the re-origin program here.
FAQs
Can You Rebuild Muscle with Myositis?
Yes, it is possible to rebuild muscle with myositis, especially with early diagnosis and the proper treatment. New therapies, such as IVIG and rituximab, have shown that muscle function and muscle strength can improve over time as inflammation decreases and the immune system is better regulated. Manual muscle testing and quantitative muscle testing are often used to assess progress.¹²
Can You Fully Recover from Myositis?
While full recovery from myositis is rare, many patients can achieve significant improvement in symptoms and quality of life with the right treatment plan. With the advent of new treatments, such as monoclonal antibodies and brain retraining, long-term remission is possible. However, ongoing management may be necessary to prevent flare-ups and maintain muscle strength.¹³
