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Therapy for dermatomyositis (DM) in patients with muscle disease begins with systemic corticosteroids. Immunosuppressive agents are considered early in therapy for their steroid-sparing effects. Thus far, the only agent tested and reported to be effective in a double-blind, placebo-controlled trial has been intravenous immunoglobulin. (Rituximab has been tested, but the results have not yet been published.) Tumor necrosis factor (TNF)-α may be involved in the pathogenesis of dermatomyositis. The TNF-α receptor antagonist etanercept blocks the binding of circulating TNF to its receptor and is effective in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. Therefore, a test of etanercept for dermatomyositis therapy is reas…