Drug treatment of juvenile dermatomyositis.

Miller, Gopika D.; Heckmatt, J. Z.; Dubowitz, Victor

doi:10.1136/adc.58.6.445

Cited by 49 publications

(9 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Dubowitz [18] pointed out that toxicity related to corticosteroids could be worse than the disease itself [17], and that "overtreatment with corticosteroids may be a factor in chronicity of the disease and failure of adequate long-term response" [18]. The latter statement has not proved to be accurate.…”

Section: After Corticosteroids (Early 1960s-early 1980s)mentioning

confidence: 97%

Long-term outcomes in juvenile dermatomyositis: How did we get here and where are we going?

Huber

Feldman²

2005

Curr Rheumatol Rep

View full text Add to dashboard Cite

Juvenile dermatomyositis (JDM) affects two to four children per million. Prior to treatment with corticosteroids, JDM had a high mortality rate (> 30%) and left 50% of those who survived with serious permanent impairments. After the introduction of corticosteroids, mortality rapidly dropped to less than 10%, and is currently reported to be less than 2% to 3%. Because most children now survive this illness, there is greater interest in long term outcomes. However, review of the literature shows while much is known about mortality, relatively little is known about long term outcomes such as physical function, quality of life, pain, educational and vocational achievement, patient satisfaction, and ongoing disease activity. Furthermore, the literature that has been published has not typically used the same outcomes making comparisons across studies difficult. Current efforts to identify key outcomes and validate measures for those outcomes will allow researchers in the future to provide this much needed information.

show abstract

Section: After Corticosteroids (Early 1960s-early 1980s)mentioning

confidence: 97%

Long-term outcomes in juvenile dermatomyositis: How did we get here and where are we going?

Huber

Feldman²

2005

Curr Rheumatol Rep

View full text Add to dashboard Cite

show abstract

“…An early uncontrolled study 27 and anecdotal case reports indicated that plasmapheresis steroid side effects such as growth retardation, osteoporosis, and gastrointestinal perforation. 78 Alternamay be effective in some adult or childhood cases of PM or DM. However, a double-blind randomized trial tively, combined therapy with prednisolone and azathioprine or methotrexate has been advocated as a comparing plasma exchange and leukapheresis with sham apheresis in 39 patients with PM or DM who means of allowing earlier and more rapid reduction in the dose of prednisolone, thereby minimizing side dictated by particular symptoms or findings on clinical examination.…”

Section: Steroid-resistant Casesmentioning

confidence: 98%

Treatment of inflammatory myopathies

Mastaglia¹,

Phillips²,

Zilko³

1997

Muscle Nerve

View full text Add to dashboard Cite

The treatment of the immune‐mediated inflammatory myopathies remains largely empirical. Corticosteroids are usually effective in polymyositis and dermatomyositis but may need to be combined with methotrexate or azathioprine in some patients. Intravenous immunoglobulin (IVIg) is effective as add‐on therapy in some patients not adequately controlled with steroids or immunosuppressive agents, but further controlled trials of IVIg are necessary to define the indications and optimal dose regimens. Cyclophosphamide, cyclosporin, or chlorambucil may be effective in patients with refractory polymyositis or dermatomyositis. Low‐dose whole body or lymphoid irradiation is a last option in severely disabled patients resistant to all other treatments. As a small proportion of patients with inclusion body myositis respond to corticosteroid or immunosuppressive therapy, a 3–6‐month trial of such therapy is justified in this condition. More specific immunotherapy for these disorders awaits identification of the target antigens and further clarification of the immunopathogenetic mechanisms. © 1997 John Wiley & Sons, Inc. Muscle Nerve 20:651–664, 1997.

show abstract

“…Of these we have formal before and after treatment assessment in 20 courses (table 2). In these 20 there was improvement in 16. In these 20 paired assessments, the mean myometry score in the five selected muscle groups showed an improvement of 2 doses (fig 2).…”

Section: Resultsmentioning

confidence: 95%

“…A starting dose of 1 mg/kg/day is used, gradually tapering off over 6-12 months, once a response has occurred. High dose steroids have no benefit over this low dose regimen and carry a risk of significant morbidity, including osteoporosis, myopathy, hypertension, gastrointestinal symptoms, and obesity.1 2 Even with low dose steroids there may be significant complications.…”

Section: Onn a Sansome V Dubowitzmentioning

confidence: 99%