Systemic Treatment for Clinically Amyopathic Dermatomyositis at 4 Tertiary Care Centers

Abstract

Nonetheless, over half of this cohort found AA to be moderately or seriously financially burdensome, and the average out-of-pocket costs of $1354 is similar to the average out-ofpocket costs of $1418 for patients with psoriasis. 4 The reallife willingness to pay of this cohort reflects the consequences of AA on the everyday lives of patients. Although future work is required to confirm these results and determine their generalizability to the overall community of patients with AA, these findings suggest that the negative psychological consequences of AA may be compounded by financial distress, which has been shown to place patients at risk for worse quality of life. 5 As payers begin to explore coverage around an increasingly promising pipeline for AA treatments, we hope that this evaluation can encourage broader financial coverage for treatments of this psychologically and financially burdensome disease-not just for pharmaceuticals, but for supplementary therapies as well. Physicians should be aware of the potential ramifications of treatment costs for patients and consider financial impairment as an unintended consequence of their recommendations.

Clinical Characteristics and Management of Patients With Clinical Amyopathic Dermatomyositis: A Retrospective Study of 64 Patients at a Tertiary Dermatology Department

“…Pinard and researchers from four tertiary care centers evaluated treatments for 115 CADM patients. They found that antimalarials alone were effective in only 11.4% (10 out of 88) and immunosuppressants were given to 80% of whole patients ( 18 ). The most commonly used immunosuppressants were MTX ( n = 59, 51.3%) and MMF or mycophenolic acid ( n = 46, 40%).…”

Hydroxychloroquine in dermatology: New perspectives on an old drug

“…In a study of 41 patients with skin‐only dermatomyositis requiring systemic therapy, only 6 (14.6%) were sufficiently managed with hydroxychloroquine alone, with the remainder needing either a change to or addition of an alternative antimalarial, methotrexate, mycophenolate mofetil, azathioprine or intravenous gamma globulin. In another recent study of 115 patients with clinically amyopathic dermatomyositis, antimalarials were the most commonly used systemic agent; however, adequate control of the skin disease occurred in only 11.4% of these cases . Furthermore, 30.7% of the patients treated with hydroxychloroquine developed a cutaneous hypersensitivity reaction …”

“…In another recent study of 115 patients with clinically amyopathic dermatomyositis, antimalarials were the most commonly used systemic agent; however, adequate control of the skin disease occurred in only 11.4% of these cases . Furthermore, 30.7% of the patients treated with hydroxychloroquine developed a cutaneous hypersensitivity reaction …”

Hidroxicloroquina: Del fármaco de herencia Inca hasta la inmunología moderna

“…El 30,7 % de los pacientes tratados con hidroxicloroquina, desarrolló una reacción de hipersensibilidad cutánea. 40 Por otra parte, en el caso de la alopecia, un reporte en 2013 describió dos pacientes de alopecia totalis con excelente respuesta a la HCQ. Pero, una serie de casos posterior, de ocho pacientes con alopecia totalis y extensa alopecia areata, sugirió que la HCQ fue ineficaz.…”