THOMAS W. BUNCH, M.D.; JOHN W. WORTHINGTON, M.D.; JOSEPH J. COMBS, M.D.; DUANE M. ILSTRUP, M.S.; ANDREW G. ENGEL, M.D.
A controlled, prospective, double-blind, therapeutic trial of azathioprine was conducted in the initial therapy of polymyositis. Sixteen patients received 60 mg prednisone per day plus either azathioprine (2 mg/kg of body weight per day) or placebo for a period of 3 months. Creatine phosphokinase (CPK) levels fell to normal slightly sooner in the placebo group, but not significantly so. The azathioprine group did not become significantly stronger (P = 0.58) and did not manifest significantly greater improvement of histopathologic features of muscle (P = 0.80) than the placebo group. Initial CPK elevations were significantly related to the degree of muscle inflammation (P = 0.037), but this was not the case at 3 months (P > 0.05). Normalization of the CPK could not be equated with disease control. Type II fiber atrophy, attributed to steroid therapy, was more marked in women than in men (P < 0.03).
BUNCH TW, WORTHINGTON JW, COMBS JJ, et al. Azathioprine with Prednisone for Polymyositis: A Controlled, Clinical Trial. Ann Intern Med. 1980;92:365–369. doi: 10.7326/0003-4819-92-3-365
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Published: Ann Intern Med. 1980;92(3):365-369.
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