PMID- 20595275
OWN - NLM
STAT- MEDLINE
DCOM- 20110214
LR  - 20131121
IS  - 1499-2752 (Electronic)
IS  - 0315-162X (Linking)
VI  - 37
IP  - 9
DP  - 2010 Sep
TI  - Treatment approaches to juvenile dermatomyositis (JDM) across North America: The 
      Childhood Arthritis and Rheumatology Research Alliance (CARRA) JDM Treatment 
      Survey.
PG  - 1953-61
LID - 10.3899/jrheum.090953 [doi]
AB  - OBJECTIVE: There are a number of different approaches to the initial treatment of 
      juvenile dermatomyositis (JDM). We assessed the therapeutic approaches of North 
      American pediatric rheumatologists to inform future studies of therapy in JDM. 
      METHODS: A survey describing clinical cases of JDM was sent to pediatric 
      rheumatologists. The cases described children with varying severity of typical 
      disease, disease with atypical features, or refractory disease. Three open-ended 
      questions were asked following each case: (1) What additional investigations 
      would you order; (2) What medicine(s) would you start (dose, route, frequency, 
      adjustment over time); and (3) What nonmedication treatment(s) would you start. 
      RESULTS: The response rate was 84% (141/167). For typical cases of JDM, 
      regardless of severity, almost all respondents used corticosteroids and another 
      medication, methotrexate (MTX) being the most commonly used. The route and 
      pattern of corticosteroid administration was variable. Intravenous immunoglobulin 
      (IVIG) was used more frequently for more severe disease, for refractory disease, 
      and for prominent cutaneous disease. Hydroxychloroquine was often used in milder 
      cases and cases principally characterized by rash. Cyclophosphamide was reserved 
      for ulcerative disease and JDM complicated by lung disease. CONCLUSION: For the 
      majority of North American pediatric rheumatologists, corticosteroids and MTX 
      appear to be the standard of care for typical cases of JDM. There is variability, 
      however, in the route of administration of corticosteroids and use of IVIG and 
      hydroxychloroquine.
FAU - Stringer, Elizabeth
AU  - Stringer E
AD  - IWK Health Centre, 5850 University Avenue, Halifax, Nova Scotia B3K 6R8. 
      Elizabeth.stringer@iwk.nshealth.ca
FAU - Bohnsack, John
AU  - Bohnsack J
FAU - Bowyer, Suzanne L
AU  - Bowyer SL
FAU - Griffin, Thomas A
AU  - Griffin TA
FAU - Huber, Adam M
AU  - Huber AM
FAU - Lang, Bianca
AU  - Lang B
FAU - Lindsley, Carol B
AU  - Lindsley CB
FAU - Ota, Sylvia
AU  - Ota S
FAU - Pilkington, Clarissa
AU  - Pilkington C
FAU - Reed, Ann M
AU  - Reed AM
FAU - Scuccimarri, Rosie
AU  - Scuccimarri R
FAU - Feldman, Brian M
AU  - Feldman BM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100701
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Antirheumatic Agents/*therapeutic use
MH  - Arthritis, Juvenile/*drug therapy
MH  - Child
MH  - Cyclophosphamide/therapeutic use
MH  - Dermatomyositis/*drug therapy
MH  - Humans
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - Methotrexate/therapeutic use
MH  - *Research Design
MH  - Therapeutic Human Experimentation
MH  - Treatment Outcome
EDAT- 2010/07/03 06:00
MHDA- 2011/02/15 06:00
CRDT- 2010/07/03 06:00
PHST- 2010/07/03 06:00 [entrez]
PHST- 2010/07/03 06:00 [pubmed]
PHST- 2011/02/15 06:00 [medline]
AID - jrheum.090953 [pii]
AID - 10.3899/jrheum.090953 [doi]
PST - ppublish
SO  - J Rheumatol. 2010 Sep;37(9):1953-61. doi: 10.3899/jrheum.090953. Epub 2010 Jul 1.