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No effective treatments have been approved for inclusion body myositis (IBM), the most common acquired inflammatory myopathy in older adults. The pathogenesis is not well understood but is thought to be mediated by inflammatory and degenerative pathways, including accumulation of misfolded protein aggregates. Arimoclomol is a hydroxylamine derivative that augments the heat shock response through transcription factor activation. This investigational (not FDA-approved) drug is postulated to inhibit protein misfolding and aggregation in IBM. In this double-blind, placebo-controlled, partially industry-funded study, 74 ambulatory adults with IBM were randomly assigned to take arimoclomol (400 mg three times daily) and 78 to placebo for 20 month…