All patients with idiopathic inflammatory myopathies (IIM) should be screened for swallowing difficulties, according to the first evidence-based guideline to be produced.
The guideline, which has been developed by a working group of the British Society for Rheumatology (BSR), also advises that all diagnosed patients should have their myositis antibody levels checked and have their overall well-being assessed. Other recommendations for all patients include the use of glucocorticoids to reduce muscle inflammation and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) for long-term treatment.
"Finally, now, we're able to standardize the way we treat adults and children with IIM," senior guideline author Hector Chinoy, PhD, said at the society's annual meeting.
It has been a long labor of love, however, taking 4 years to get the guideline published, said Chinoy, professor of rheumatology and neuromuscular disease at the University of Manchester (England), and a consultant at Salford (England) Royal Hospital.
"We're not covering diagnosis, classification, or the investigation of suspected IIM," said Chinoy. Inclusion body myositis also is not included.
Altogether, there are 13 recommendations that have been developed using a PICO (patient or population, intervention, comparison, outcome) format, graded based on the quality of the available evidence, and then voted on by the working group members to give a score of the strength of agreement.