Treatment Approaches to Juvenile Dermatomyositis (JDM) Across North America: The Childhood Arthritis and Rheumatology Research Alliance (CARRA) JDM Treatment Survey
Identifieur interne : 001759 ( Main/Exploration ); précédent : 001758; suivant : 001760Treatment Approaches to Juvenile Dermatomyositis (JDM) Across North America: The Childhood Arthritis and Rheumatology Research Alliance (CARRA) JDM Treatment Survey
Auteurs : Elizabeth Stringer [Canada, États-Unis, Royaume-Uni] ; John Bohnsack ; Suzanne L. Bowyer ; Thomas A. Griffin ; Adam M. Huber ; Bianca Lang ; Carol B. Lindsley ; Sylvia Ota ; Clarissa Pilkington ; Ann M. Reed ; Rosie Scuccimarri ; Brian M. FeldmanSource :
- Journal of rheumatology [ 0315-162X ] ; 2010.
Descripteurs français
- KwdFr :
- Antirhumatismaux (usage thérapeutique), Arthrite juvénile (traitement médicamenteux), Cyclophosphamide (usage thérapeutique), Dermatomyosite (traitement médicamenteux), Enfant, Expérimentation thérapeutique humaine, Hormones corticosurrénaliennes (usage thérapeutique), Humains, Immunoglobulines par voie veineuse (usage thérapeutique), Méthotrexate (usage thérapeutique), Plan de recherche, Résultat thérapeutique.
- MESH :
- traitement médicamenteux : Arthrite juvénile, Dermatomyosite.
- usage thérapeutique : Antirhumatismaux, Cyclophosphamide, Hormones corticosurrénaliennes, Immunoglobulines par voie veineuse, Méthotrexate.
- Pascal (Inist)
- Wicri :
English descriptors
- KwdEn :
- Adolescent, Adrenal Cortex Hormones (therapeutic use), Antirheumatic Agents (therapeutic use), Arthritis, Arthritis, Juvenile (drug therapy), Child, Cyclophosphamide (therapeutic use), Dermatomyositis, Dermatomyositis (drug therapy), Humans, Immunoglobulins, Intravenous (therapeutic use), Methotrexate (therapeutic use), Myositis, North America, Pediatrics, Research Design, Rheumatology, Surgical approach, Survey, Therapeutic Human Experimentation, Treatment, Treatment Outcome.
- MESH :
- chemical , therapeutic use : Adrenal Cortex Hormones, Antirheumatic Agents, Cyclophosphamide, Immunoglobulins, Intravenous, Methotrexate.
- drug therapy : Arthritis, Juvenile, Dermatomyositis.
- Child, Humans, Research Design, Therapeutic Human Experimentation, Treatment Outcome.
Abstract
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.
Affiliations:
- Canada, Royaume-Uni, États-Unis
- Angleterre, Grand Londres, Indiana, Kansas, Minnesota, Ohio, Utah
- Londres
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Bowyer</name></author><author><name sortKey="Griffin, Thomas A" sort="Griffin, Thomas A" uniqKey="Griffin T" first="Thomas A." last="Griffin">Thomas A. Griffin</name></author><author><name sortKey="Huber, Adam M" sort="Huber, Adam M" uniqKey="Huber A" first="Adam M." last="Huber">Adam M. Huber</name></author><author><name sortKey="Lang, Bianca" sort="Lang, Bianca" uniqKey="Lang B" first="Bianca" last="Lang">Bianca Lang</name></author><author><name sortKey="Lindsley, Carol B" sort="Lindsley, Carol B" uniqKey="Lindsley C" first="Carol B." last="Lindsley">Carol B. Lindsley</name></author><author><name sortKey="Ota, Sylvia" sort="Ota, Sylvia" uniqKey="Ota S" first="Sylvia" last="Ota">Sylvia Ota</name></author><author><name sortKey="Pilkington, Clarissa" sort="Pilkington, Clarissa" uniqKey="Pilkington C" first="Clarissa" last="Pilkington">Clarissa Pilkington</name></author><author><name sortKey="Reed, Ann M" sort="Reed, Ann M" uniqKey="Reed A" first="Ann M." last="Reed">Ann M. Reed</name></author><author><name sortKey="Scuccimarri, Rosie" sort="Scuccimarri, Rosie" uniqKey="Scuccimarri R" first="Rosie" last="Scuccimarri">Rosie Scuccimarri</name></author><author><name sortKey="Feldman, Brian M" sort="Feldman, Brian M" uniqKey="Feldman B" first="Brian M." last="Feldman">Brian M. Feldman</name></author></analytic><series><title level="j" type="main">Journal of rheumatology</title><title level="j" type="abbreviated">J. rheumatol.</title><idno type="ISSN">0315-162X</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of rheumatology</title><title level="j" type="abbreviated">J. rheumatol.</title><idno type="ISSN">0315-162X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adrenal Cortex Hormones (therapeutic use)</term><term>Antirheumatic Agents (therapeutic use)</term><term>Arthritis</term><term>Arthritis, Juvenile (drug therapy)</term><term>Child</term><term>Cyclophosphamide (therapeutic use)</term><term>Dermatomyositis</term><term>Dermatomyositis (drug therapy)</term><term>Humans</term><term>Immunoglobulins, Intravenous (therapeutic use)</term><term>Methotrexate (therapeutic use)</term><term>Myositis</term><term>North America</term><term>Pediatrics</term><term>Research Design</term><term>Rheumatology</term><term>Surgical approach</term><term>Survey</term><term>Therapeutic Human Experimentation</term><term>Treatment</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Antirhumatismaux (usage thérapeutique)</term><term>Arthrite juvénile (traitement médicamenteux)</term><term>Cyclophosphamide (usage thérapeutique)</term><term>Dermatomyosite (traitement médicamenteux)</term><term>Enfant</term><term>Expérimentation thérapeutique humaine</term><term>Hormones corticosurrénaliennes (usage thérapeutique)</term><term>Humains</term><term>Immunoglobulines par voie veineuse (usage thérapeutique)</term><term>Méthotrexate (usage thérapeutique)</term><term>Plan de recherche</term><term>Résultat thérapeutique</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Adrenal Cortex Hormones</term><term>Antirheumatic Agents</term><term>Cyclophosphamide</term><term>Immunoglobulins, Intravenous</term><term>Methotrexate</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Arthritis, Juvenile</term><term>Dermatomyositis</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Arthrite juvénile</term><term>Dermatomyosite</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antirhumatismaux</term><term>Cyclophosphamide</term><term>Hormones corticosurrénaliennes</term><term>Immunoglobulines par voie veineuse</term><term>Méthotrexate</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Child</term><term>Humans</term><term>Research Design</term><term>Therapeutic Human Experimentation</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Enfant</term><term>Expérimentation thérapeutique humaine</term><term>Humains</term><term>Plan de recherche</term><term>Résultat thérapeutique</term><term>Traitement</term><term>Voie abord</term><term>Dermatomyosite</term><term>Adolescent</term><term>Amérique du Nord</term><term>Enfant</term><term>Arthrite</term><term>Rhumatologie</term><term>Enquête</term><term>Pédiatrie</term><term>Myosite</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Enfant</term><term>Pédiatrie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><affiliations><list><country><li>Canada</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Indiana</li><li>Kansas</li><li>Minnesota</li><li>Ohio</li><li>Utah</li></region><settlement><li>Londres</li></settlement></list><tree><noCountry><name sortKey="Bohnsack, John" sort="Bohnsack, John" uniqKey="Bohnsack J" first="John" last="Bohnsack">John Bohnsack</name><name sortKey="Bowyer, Suzanne L" sort="Bowyer, Suzanne L" uniqKey="Bowyer S" first="Suzanne L." last="Bowyer">Suzanne L. Bowyer</name><name sortKey="Feldman, Brian M" sort="Feldman, Brian M" uniqKey="Feldman B" first="Brian M." last="Feldman">Brian M. Feldman</name><name sortKey="Griffin, Thomas A" sort="Griffin, Thomas A" uniqKey="Griffin T" first="Thomas A." last="Griffin">Thomas A. Griffin</name><name sortKey="Huber, Adam M" sort="Huber, Adam M" uniqKey="Huber A" first="Adam M." last="Huber">Adam M. Huber</name><name sortKey="Lang, Bianca" sort="Lang, Bianca" uniqKey="Lang B" first="Bianca" last="Lang">Bianca Lang</name><name sortKey="Lindsley, Carol B" sort="Lindsley, Carol B" uniqKey="Lindsley C" first="Carol B." last="Lindsley">Carol B. Lindsley</name><name sortKey="Ota, Sylvia" sort="Ota, Sylvia" uniqKey="Ota S" first="Sylvia" last="Ota">Sylvia Ota</name><name sortKey="Pilkington, Clarissa" sort="Pilkington, Clarissa" uniqKey="Pilkington C" first="Clarissa" last="Pilkington">Clarissa Pilkington</name><name sortKey="Reed, Ann M" sort="Reed, Ann M" uniqKey="Reed A" first="Ann M." last="Reed">Ann M. Reed</name><name sortKey="Scuccimarri, Rosie" sort="Scuccimarri, Rosie" uniqKey="Scuccimarri R" first="Rosie" last="Scuccimarri">Rosie Scuccimarri</name></noCountry><country name="Canada"><noRegion><name sortKey="Stringer, Elizabeth" sort="Stringer, Elizabeth" uniqKey="Stringer E" first="Elizabeth" last="Stringer">Elizabeth Stringer</name></noRegion><name sortKey="Stringer, Elizabeth" sort="Stringer, Elizabeth" uniqKey="Stringer E" first="Elizabeth" last="Stringer">Elizabeth Stringer</name><name sortKey="Stringer, Elizabeth" sort="Stringer, Elizabeth" uniqKey="Stringer E" first="Elizabeth" last="Stringer">Elizabeth Stringer</name></country><country name="États-Unis"><region name="Utah"><name sortKey="Stringer, Elizabeth" sort="Stringer, Elizabeth" uniqKey="Stringer E" first="Elizabeth" last="Stringer">Elizabeth Stringer</name></region><name sortKey="Stringer, Elizabeth" sort="Stringer, Elizabeth" uniqKey="Stringer E" first="Elizabeth" last="Stringer">Elizabeth Stringer</name><name sortKey="Stringer, Elizabeth" sort="Stringer, Elizabeth" uniqKey="Stringer E" first="Elizabeth" last="Stringer">Elizabeth Stringer</name><name sortKey="Stringer, Elizabeth" sort="Stringer, Elizabeth" uniqKey="Stringer E" first="Elizabeth" last="Stringer">Elizabeth Stringer</name><name sortKey="Stringer, Elizabeth" sort="Stringer, Elizabeth" uniqKey="Stringer E" first="Elizabeth" last="Stringer">Elizabeth Stringer</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Stringer, Elizabeth" sort="Stringer, Elizabeth" uniqKey="Stringer E" first="Elizabeth" last="Stringer">Elizabeth Stringer</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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