Azathioprine with Prednisone for Polymyositis

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Abstract
A controlled, prospective, double-blind, therapeutic trial of azathioprine [AP; purine antagonist] was conducted in the initial therapy of polymyositis. Patients [16] received 60 mg pregnisone/day plus AP (2 mg/kg of body weight/day) or placebo for a period of 3 mo. Creatine phosphokinase (CPK) levels fell to normal slightly sooner in the placebo group, but not significantly so. The AP group did not become significantly stronger and did not manifest significantly greater improvement of histopathologic features of muscle than the placebo group. Initial CPK elevations were significantly related to the degree of muscle inflammation, but this was not the case at 3 mo. 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).