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Treatment Approaches to Juvenile Dermatomyositis (JDM) Across North America: The Childhood Arthritis and Rheumatology Research Alliance (CARRA) JDM Treatment Survey

Identifieur interne : 000050 ( PascalFrancis/Curation ); précédent : 000049; suivant : 000051

Treatment 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. Feldman

Source :

RBID : Pascal:10-0446161

Descripteurs français

English descriptors

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.
pA  
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A08 01  1  ENG  @1 Treatment Approaches to Juvenile Dermatomyositis (JDM) Across North America: The Childhood Arthritis and Rheumatology Research Alliance (CARRA) JDM Treatment Survey
A11 01  1    @1 STRINGER (Elizabeth)
A11 02  1    @1 BOHNSACK (John)
A11 03  1    @1 BOWYER (Suzanne L.)
A11 04  1    @1 GRIFFIN (Thomas A.)
A11 05  1    @1 HUBER (Adam M.)
A11 06  1    @1 LANG (Bianca)
A11 07  1    @1 LINDSLEY (Carol B.)
A11 08  1    @1 OTA (Sylvia)
A11 09  1    @1 PILKINGTON (Clarissa)
A11 10  1    @1 REED (Ann M.)
A11 11  1    @1 SCUCCIMARRI (Rosie)
A11 12  1    @1 FELDMAN (Brian M.)
A14 01      @1 IWK Health Centre @2 Halifax, Nova Scotia @3 CAN
A14 02      @1 University of Utah School of Medicine @2 Salt Lake City, Utah @3 USA
A14 03      @1 Indiana University School of Medicine @2 Indianapolis, Indiana @3 USA
A14 04      @1 Cincinnati Children's Hospital @2 Cincinnati, Ohio @3 USA
A14 05      @1 University of Kansas Medical Center @2 Kansas City, Kansas @3 USA
A14 06      @1 The Hospital for Sick Children @2 Toronto, Ontario @3 CAN
A14 07      @1 Great Ormond Street Hospital for Children @2 London @3 GBR
A14 08      @1 Mayo Clinic @2 Rochester, Minnesota @3 USA
A14 09      @1 Montreal Children's Hospital @2 Montreal, Quebec @3 CAN
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C01 01    ENG  @0 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.
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Pascal:10-0446161

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<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>
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<s1>REED (Ann M.)</s1>
</fA11>
<fA11 i1="11" i2="1">
<s1>SCUCCIMARRI (Rosie)</s1>
</fA11>
<fA11 i1="12" i2="1">
<s1>FELDMAN (Brian M.)</s1>
</fA11>
<fA14 i1="01">
<s1>IWK Health Centre</s1>
<s2>Halifax, Nova Scotia</s2>
<s3>CAN</s3>
</fA14>
<fA14 i1="02">
<s1>University of Utah School of Medicine</s1>
<s2>Salt Lake City, Utah</s2>
<s3>USA</s3>
</fA14>
<fA14 i1="03">
<s1>Indiana University School of Medicine</s1>
<s2>Indianapolis, Indiana</s2>
<s3>USA</s3>
</fA14>
<fA14 i1="04">
<s1>Cincinnati Children's Hospital</s1>
<s2>Cincinnati, Ohio</s2>
<s3>USA</s3>
</fA14>
<fA14 i1="05">
<s1>University of Kansas Medical Center</s1>
<s2>Kansas City, Kansas</s2>
<s3>USA</s3>
</fA14>
<fA14 i1="06">
<s1>The Hospital for Sick Children</s1>
<s2>Toronto, Ontario</s2>
<s3>CAN</s3>
</fA14>
<fA14 i1="07">
<s1>Great Ormond Street Hospital for Children</s1>
<s2>London</s2>
<s3>GBR</s3>
</fA14>
<fA14 i1="08">
<s1>Mayo Clinic</s1>
<s2>Rochester, Minnesota</s2>
<s3>USA</s3>
</fA14>
<fA14 i1="09">
<s1>Montreal Children's Hospital</s1>
<s2>Montreal, Quebec</s2>
<s3>CAN</s3>
</fA14>
<fA20>
<s1>1953-1961</s1>
</fA20>
<fA21>
<s1>2010</s1>
</fA21>
<fA23 i1="01">
<s0>ENG</s0>
</fA23>
<fA43 i1="01">
<s1>INIST</s1>
<s2>16024</s2>
<s5>354000194840140270</s5>
</fA43>
<fA44>
<s0>0000</s0>
<s1>© 2010 INIST-CNRS. All rights reserved.</s1>
</fA44>
<fA45>
<s0>43 ref.</s0>
</fA45>
<fA47 i1="01" i2="1">
<s0>10-0446161</s0>
</fA47>
<fA60>
<s1>P</s1>
</fA60>
<fA61>
<s0>A</s0>
</fA61>
<fA64 i1="01" i2="1">
<s0>Journal of rheumatology</s0>
</fA64>
<fA66 i1="01">
<s0>CAN</s0>
</fA66>
<fC01 i1="01" l="ENG">
<s0>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.</s0>
</fC01>
<fC02 i1="01" i2="X">
<s0>002B15I</s0>
</fC02>
<fC02 i1="02" i2="X">
<s0>002B07</s0>
</fC02>
<fC02 i1="03" i2="X">
<s0>002B17H</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE">
<s0>Traitement</s0>
<s5>07</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG">
<s0>Treatment</s0>
<s5>07</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA">
<s0>Tratamiento</s0>
<s5>07</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE">
<s0>Voie abord</s0>
<s5>08</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG">
<s0>Surgical approach</s0>
<s5>08</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA">
<s0>Vía abordaje</s0>
<s5>08</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE">
<s0>Dermatomyosite</s0>
<s5>09</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG">
<s0>Dermatomyositis</s0>
<s5>09</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA">
<s0>Dermatomiositis</s0>
<s5>09</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE">
<s0>Adolescent</s0>
<s5>10</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG">
<s0>Adolescent</s0>
<s5>10</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA">
<s0>Adolescente</s0>
<s5>10</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE">
<s0>Amérique du Nord</s0>
<s2>NG</s2>
<s5>13</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG">
<s0>North America</s0>
<s2>NG</s2>
<s5>13</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA">
<s0>America del norte</s0>
<s2>NG</s2>
<s5>13</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE">
<s0>Enfant</s0>
<s5>14</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG">
<s0>Child</s0>
<s5>14</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA">
<s0>Niño</s0>
<s5>14</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE">
<s0>Arthrite</s0>
<s5>15</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG">
<s0>Arthritis</s0>
<s5>15</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA">
<s0>Artritis</s0>
<s5>15</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE">
<s0>Rhumatologie</s0>
<s5>16</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG">
<s0>Rheumatology</s0>
<s5>16</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA">
<s0>Reumatología</s0>
<s5>16</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE">
<s0>Enquête</s0>
<s5>17</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG">
<s0>Survey</s0>
<s5>17</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA">
<s0>Encuesta</s0>
<s5>17</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE">
<s0>Pédiatrie</s0>
<s5>18</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG">
<s0>Pediatrics</s0>
<s5>18</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA">
<s0>Pediatría</s0>
<s5>18</s5>
</fC03>
<fC03 i1="11" i2="X" l="FRE">
<s0>Myosite</s0>
<s5>19</s5>
</fC03>
<fC03 i1="11" i2="X" l="ENG">
<s0>Myositis</s0>
<s5>19</s5>
</fC03>
<fC03 i1="11" i2="X" l="SPA">
<s0>Miositis</s0>
<s5>19</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE">
<s0>Homme</s0>
</fC07>
<fC07 i1="01" i2="X" l="ENG">
<s0>Human</s0>
</fC07>
<fC07 i1="01" i2="X" l="SPA">
<s0>Hombre</s0>
</fC07>
<fC07 i1="02" i2="X" l="FRE">
<s0>Amérique</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="02" i2="X" l="ENG">
<s0>America</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="02" i2="X" l="SPA">
<s0>America</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="03" i2="X" l="FRE">
<s0>Maladie autoimmune</s0>
<s5>37</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG">
<s0>Autoimmune disease</s0>
<s5>37</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA">
<s0>Enfermedad autoinmune</s0>
<s5>37</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE">
<s0>Maladie de système</s0>
<s5>38</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG">
<s0>Systemic disease</s0>
<s5>38</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA">
<s0>Enfermedad sistémica</s0>
<s5>38</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE">
<s0>Pathologie du muscle strié</s0>
<s5>39</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG">
<s0>Striated muscle disease</s0>
<s5>39</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA">
<s0>Músculo estriado patología</s0>
<s5>39</s5>
</fC07>
<fC07 i1="06" i2="X" l="FRE">
<s0>Pathologie de la peau</s0>
<s5>40</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG">
<s0>Skin disease</s0>
<s5>40</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA">
<s0>Piel patología</s0>
<s5>40</s5>
</fC07>
<fC07 i1="07" i2="X" l="FRE">
<s0>Pathologie du tissu conjonctif</s0>
<s5>41</s5>
</fC07>
<fC07 i1="07" i2="X" l="ENG">
<s0>Connective tissue disease</s0>
<s5>41</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA">
<s0>Tejido conjuntivo patología</s0>
<s5>41</s5>
</fC07>
<fC07 i1="08" i2="X" l="FRE">
<s0>Immunopathologie</s0>
<s5>42</s5>
</fC07>
<fC07 i1="08" i2="X" l="ENG">
<s0>Immunopathology</s0>
<s5>42</s5>
</fC07>
<fC07 i1="08" i2="X" l="SPA">
<s0>Inmunopatología</s0>
<s5>42</s5>
</fC07>
<fC07 i1="09" i2="X" l="FRE">
<s0>Pathologie du système ostéoarticulaire</s0>
<s5>43</s5>
</fC07>
<fC07 i1="09" i2="X" l="ENG">
<s0>Diseases of the osteoarticular system</s0>
<s5>43</s5>
</fC07>
<fC07 i1="09" i2="X" l="SPA">
<s0>Sistema osteoarticular patología</s0>
<s5>43</s5>
</fC07>
<fN21>
<s1>291</s1>
</fN21>
<fN44 i1="01">
<s1>OTO</s1>
</fN44>
<fN82>
<s1>OTO</s1>
</fN82>
</pA>
</standard>
</inist>
</record>

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   |wiki=    Sante
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   |texte=   Treatment Approaches to Juvenile Dermatomyositis (JDM) Across North America: The Childhood Arthritis and Rheumatology Research Alliance (CARRA) JDM Treatment Survey
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