Pharmacokinetic study of oral prednisolone compared with intravenous methylprednisolone in patients with juvenile dermatomyositis

Rouster‐Stevens, Kelly; Gursahaney, Aneel; Ngai, Ka Leung; Daru, Jennifer A.; Pachman, Lauren M.

doi:10.1002/art.23341

Cited by 86 publications

(57 citation statements)

References 19 publications

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“…Studies in patients with Juvenile Dermatomyositis, which shares some clinical similarities to cGVHD, have shown that patients with endothelial damage have compromised absorption of oral prednisone. 8 This altered vascularity is seen in the capillaries of the nail beds and is directly correlated with altered vascularity of the endothelium. 9 Although it has not yet been tested in cGVHD, it is hypothesized that cGVHD mimics this pattern of inflammation, since Biedermann et al 10 has shown that in biopsy specimen of patients with cGVHD there is loss of microvessels.…”

Section: Discussionmentioning

confidence: 99%

Weight loss and reduced body mass index: a critical issue in children with multiorgan chronic graft-versus-host disease

Browning

Thormann

Seshadri

et al. 2006

Bone Marrow Transplant

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Weight loss and malnutrition are major problems in patients with chronic graft-versus-host disease (GVHD). In adults, low body mass index (BMI) is a predictor for mortality; however, weight loss and BMI have not been studied in pediatric chronic GVHD. A retrospective study on 18 children with extensive chronic GVHD was completed. Median age at SCT was 12.3 (range 0.6-23) years; age at chronic GVHD diagnosis was 12.5 (1-23) years. Patients with multiorgan involvement had a mean maximal decrease in BMI of 20.9% and most dropped below 10th percentile in expected weight-for-age. This change in BMI not only indicates a significant decrease in weight but often a plateau in stature. In contrast, patients with one organ system involved had a mean maximal decrease in BMI of 5% and did not fall below 10th percentile. All patients with multiorgan involvement required salvage therapy beyond steroids and CSA. Three patients died due to complications of chronic GVHD. Weight loss and malnutrition (as reflected by a decrease in BMI) are clinically significant issues in children with multisystem chronic GVHD. Weight loss is likely another systemic manifestation of the disease and may contribute, along with other factors such as increased immunosuppression and infection, to increased mortality in this group.

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Section: Discussionmentioning

confidence: 99%

Weight loss and reduced body mass index: a critical issue in children with multiorgan chronic graft-versus-host disease

Browning

Thormann

Seshadri

et al. 2006

Bone Marrow Transplant

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“…Esophageal dysmotility and malabsorption with decreased absorption of nutrients, and perhaps of oral medications, have been described [32].…”

Section: Gastrointestinal Involvementmentioning

confidence: 99%

Juvenile Dermatomyositis

Batthish

Feldman

2011

Curr Rheumatol Rep

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“…Moreover, a study published in 2000 [47] suggested that IV MP although more costly, is cost effective when compared to oral corticosteroids. In the presence of dysphagia, gastrointestinal symptoms or more severe disease, IV MP is generally used as there is reported reduced absorption of oral prednisolone, especially when gastrointestinal vasculopathy is suspected [48]. Many specialist centres now prefer the use of IV MP pulses for 3-5 days followed by a 2mg/kg/day dose of prednisolone (or IV MP equivalent) and the subsequent oral steroid dose to be given as a single morning dose, as this regimen has less effects on the hypothalamic-pituitary-adrenal function and growth, even in young children [49].…”

Section: Corticosteroidsmentioning

confidence: 99%

Treatment of Juvenile Dermatomyositis: An Update

Papadopoulou

Wedderburn

2017

Pediatr Drugs

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Abstract:The Idiopathic Inflammatory Myopathies of childhood consist a heterogeneous group of autoimmune diseases characterised by proximal muscle weakness and pathognomonic skin rashes. The overall prognosis of juvenile myositis has improved significantly over recent years, but the long-term outcome differs substantially from patient to patient suggestive of distinct clinical phenotypes with variable responses to treatment. High doses of corticosteroids remain the cornerstone of therapy along with other immunosuppressant therapies depending on disease severity and response. The advent of biological drugs has revolutionised the management of various paediatric rheumatologic diseases, including inflammatory myopathies. There are few data from randomised controlled trials to guide management decisions, thus several algorithms for the treatment of juvenile myositis have been developed using international expert opinion. The general treatment goals now include elimination of active disease and normalization of physical function, so as to preserve normal growth and development, and to prevent long-term damage and deformities. This review summarizes the newer and possible future therapies of juvenile inflammatory myopathies, including evidence supporting their efficacy and safety.

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Pharmacokinetic study of oral prednisolone compared with intravenous methylprednisolone in patients with juvenile dermatomyositis

Cited by 86 publications

References 19 publications

Weight loss and reduced body mass index: a critical issue in children with multiorgan chronic graft-versus-host disease

Weight loss and reduced body mass index: a critical issue in children with multiorgan chronic graft-versus-host disease

Juvenile Dermatomyositis

Treatment of Juvenile Dermatomyositis: An Update

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