Nonpharmacological management for idiopathic inflammatory myopathies

Managing idiopathic inflammatory myopathies requires specialist supervision and people usually need lifelong treatment and monitoring.

Regular screening for complications of disease (eg interstitial lung disease, digital ulceration, dysphagia) and coexistent malignancy is vital for early intervention and management. Malignancy (including lung, breast and ovarian carcinoma, and lymphomaSchmidt, 2018) can occur before, concurrently, or after the diagnosis of myopathy, so the risk of a person developing malignancy requires ongoing vigilance.

Exercise is an important aspect of treating people with idiopathic inflammatory myopathy. Strength training is recommended, which is safe and improves muscle strength, function and health-related quality of life. Exercise is particularly important for people with interstitial lung disease. Management may be supportive and include physiotherapy, structured exercise programs and mobility aids.

Dysphagia is a common problem and some people will require referral to a gastroenterologist for placement of a gastrostomy to enable enteral nutrition support. Optimising nutrition is an important facet of management, not only for those who require enteral feeding.