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Dermbits

For patients with extensive skin disease from dermatomyositis, are you still trying traditional immunosuppressants prior to moving to IVIG?

Connective Tissue Diseases

I do move to IVIG a lot sooner. IviG was approved recently by the FDA for dermatomycitis, so that certainly made it easier to get insurance approval. Pre FDA approval. Getting IViG was a little hard, and the insurance sort of made you go through the wringer of trying other immune suppressants. But certainly IVig has a great role in skin DM, which isn't responsive to other immune therapies. So I really move to IVIG sometimes even as a first step if a patient has really bad DM involving the skin, and often as a second line if they haven't responded to one conventional immune suppressant, just because sometimes insurance gives me a hard time.