Rheumatology Medical News about Dermatomyositis Child Systemic Corticosteroids

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Favorable Outcome of Juvenile Dermatomyositis Treated without Systemic Corticosteroids
The Journal of Pediatrics, 10/27/09

Levy DM et al. – Systemic corticosteroids can be avoided in a select group of patients with JDM. Alternative agents such as methotrexate and IVIG may be prescribed to effectively treat JDM and prevent complications.

Methods

A retrospective study of 38 patients with JDM treated at a tertiary care children's hospital identified 8 patients who had never received corticosteroids.
Disease presentation and course, pharmacologic, and ancillary treatments were recorded.

Results

Patients in the no corticosteroid group were followed for a median of 2.8 years (range, 2.1 to 9.5 years).
Treatment was primarily with intravenous immunoglobulin (IVIG) (75%) and methotrexate (50%), with favorable response in all.
No serious treatment complications were observed; headaches were reported by 3 patients receiving IVIG.
Two patients had a myositis flare after discontinuing all medications for more than 1 year; complete resolution of symptoms was observed after either 1 or 2 further doses of IVIG.
Two patients had calcinosis (at 1 and 9 years of disease); however, no patient had joint contractures, muscle atrophy, lipodystrophy, or functional limitations.

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