Treatment escalation patterns to start biologics in refractory moderate juvenile dermatomyositis among members of the Childhood Arthritis and Rheumatology Research Alliance
Authors' conclusion
Most respondents favored starting a biologic earlier in disease course after trialing up to two conventional DMARDs, specifically including methotrexate. There was a clear preference for rituximab.
Study context
- Population
- Childhood Arthritis and Rheumatology Research Alliance (CARRA) members interested in juvenile dermatomyositis (JDM); case of moderately severe JDM refractory to MTX, GC and IVIG
- Participants
- 121 CARRA members
- Outcome
- Treatment escalation practices for refractory moderate JDM
Methodological detailssurvey, consensus framework (80% agreement), online, Respondents: 88% pediatric rheumatologists, 85% practiced in the United States, 43% over 10 years of experience
- Survey
- Consensus framework (80% agreement)
- Online
- Respondents: 88% pediatric rheumatologists, 85% practiced in the United States, 43% over 10 years of experience
Main finding
As reported in the abstract
Would initiate a biologic after failing 1-2 non-biologic disease-modifying antirheumatic drugs (DMARDs)
≈80%
Trial of MTX considered necessary before a biologic
96%
Trial of mycophenolate considered necessary before a biologic
60%
Would start a biologic by 4 months from diagnosis
Over 50%
Observational data: associations, not effects.
Original publication
Treatment escalation patterns to start biologics in refractory moderate juvenile dermatomyositis among members of the Childhood Arthritis and Rheumatology Research Alliance. Pediatr Rheumatol Online J. Published 6 January 2023. doi:10.
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