ASSESSMENT OF MUSCLE STRENGTH AND CREATINE KINASE LEVELS IN POLYMYOSITIS PATIENTS- PRE AND POST TREATMENT WITH STEROIDS AND MMF

Abstract

Background: Polymyositis is an inflammatory myopathy characterised by muscle inflammation and weakness. Treatment typically involves immunosuppressive therapies, including steroids and mycophenolate mofetil (MMF). The aim of this study were to assess the effectiveness of these treatments using muscle strength and serum creatine kinase (CK) levels, with reductions in CK indicating decreased muscle damage and improved muscle strength reflecting clinical recovery. Methodology: A retrospective observational study was conducted in polymyositis patients undergoing treatment with steroids and mycophenolate mofetil (MMF). Patients received a combination of steroids and MMF for 24 weeks. Steroid dosing was individualized based on disease severity and response, while MMF was administered at a standard dosage of 2 grams per day. Muscle strength and creatine kinase (CK) levels were assessed at baseline upto after 24 weeks of treatment. The primary outcome measures were muscle strength, assessed using manual muscle testing (MMT), and serum CK levels measured in units per liter (U/ L). Statistical analysis included Repeated Measures ANOVA to assess changes in muscle strength from baseline to 24 weeks post-treatment and Paired T-test to compare baseline and post-treatment CK levels. All analyses were performed using statistical software, with significance set at p < 0.001. Results: The study group included 20 polymyositis patients (10 males and 10 females) with elevated baseline CK levels and confirmed diagnoses of polymyositis. The Repeated Measures ANOVA indicated a highly significant improvement in muscle strength from baseline to 24 weeks post-treatment (p < 0.001). The improvement in muscle strength post treatment suggests that the combination therapy was effective in enhancing muscle function. The Paired T-test showed a highly significant reduction in CK levels post-treatment (p < 0.001). Baseline CK levels (mean   ±SD) were significantly higher compared to post-treatment levels, indicating a reduction in muscle inflammation and damage following the treatment. Conclusion: The combination of steroids and MMF significantly improves muscle strength and reduces CK levels in polymyositis patients, with very highly significant p-values (p < 0.001) for both measures. These findings highlight the effectiveness of steroid and MMF therapy in reducing muscle damage and enhancing muscle function. The significant improvements in muscle strength and CK levels support the use of these treatments for polymyositis. Clinicians should consider these therapies to improve patient outcomes, using CK levels and manual muscle testing (MMT) as reliable, cost effective indicators for monitoring treatment efficacy, offering advantages over more expensive and less accessible imaging techniques.