Other Treatments

Immunosuppressive therapy has been used to treat patients with acute myocarditis; however, no good evidence exists to support its use. The Myocarditis Treatment Trial randomised 111 patients with biopsy proven myocarditis to receive placebo or immunosuppression with prednisolone plus either cyclosporine or azathioprine for 24 weeks [1]. There was no significant difference in improvements in left ventricular function or mortality between the groups. A Cochrane review in 2006 of the use of corticosteroids for myocarditis identified no randomised controlled trials that met their inclusion criteria [8].

Immunosuppression may have a role in patients with myocarditis as part of a systemic autoimmune disease.

Intravenous immunoglobulin has also been used to treat acute myocarditis. It is still frequently administered to children. However, a 2005 Cochrane review of the use of intravenous immunoglobulin for presumed viral myocarditis found no evidence to support its use [9].