Abstract

Purpose of reviewThe purpose of this study is to review recent scientific advances relating to the natural history, cause, treatment and serum and imaging biomarkers of inclusion body myositis (IBM).Recent findingsSeveral theories regarding the aetiopathogenesis of IBM are being explored and new therapeutic approaches are being investigated. New diagnostic criteria have been proposed, reflecting the knowledge that the diagnostic pathological findings may be absent in patients with clinically typical IBM. The role of MRI in IBM is expanding and knowledge about pathological biomarkers is increasing. The recent description of autoantibodies to cytosolic 5′ nucleotidase 1A in patients with IBM is a potentially important advance that may aid early diagnosis and provides new evidence regarding the role of autoimmunity in IBM.SummaryIBM remains an enigmatic and often misdiagnosed disease. The pathogenesis of the disease is still not fully understood. To date, pharmacological treatment trials have failed to show clear efficacy. Future research should continue to focus on improving understanding of the pathophysiological mechanisms of the disease and on the identification of reliable and sensitive outcome measures for clinical trials. IBM is a rare disease and international multicentre collaboration for trials is important to translate research advances into improved patient outcomes.

Highlights

  • Sporadic inclusion body myositis (IBM) is the commonest acquired myopathy in patients aged over 50 years [1]

  • This is reflected by the inclusion of a clinically defined group in the new 2011 European Neuromuscular Centre (ENMC) diagnostic criteria [9], which build on the MRC Centre criteria [10,11]

  • This review focuses on our current knowledge of IBM with particular emphasis on developments in the last 24 months in disease, serum and imaging biomarkers and on on-going and future therapeutic trials

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Summary

INTRODUCTION

Sporadic inclusion body myositis (IBM) is the commonest acquired myopathy in patients aged over 50 years [1]. Several pathological findings on muscle biopsy are considered as synonymous with the diagnosis of IBM: an endomysial inflammatory infiltrate, invasion of nonnecrotic muscle fibres by inflammatory cells (partial invasion), rimmed vacuoles, amyloid and 15–18 nm tubulofilaments on electron microscopy. Combinations of these features have formed the basis of successive diagnostic criteria for IBM [4,5,6,7]. 1040-8711 ß 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins www.co-rheumatology.com

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