Literature Review

Drug treatment progress on juvenile dermatomyositis

  • Yanru Reviewer: SUN ,
  • Li Reviser: LIU
Expand
  • Department of General Medicine, Children's Hospital of Tianjin University, Tianjin 300074, China

Received date: 2021-10-25

  Online published: 2022-05-13

Abstract

Juvenile dermatomyositis (JDM) is an autoimmune inflammatory myopathy in childhood that can affect the whole body, mainly the skin and proximal muscles. It can also affect vital organs (such as: lungs, joints, and gastrointestinal tract etc), often accompanied by the presence of specific antibodies. At present, the treatment of JDM is very difficult. The first-line drugs are glucocorticoids and methotrexate. For patients with poor therapeutic effects, some second-line or third-line drugs may play a supportive role. In refractory patients, intravenous injection of immunoglobulin or cyclophosphamide may be effective, while biologics and small molecule targeted drugs are gradually used in clinical practice. In addition to glucocorticoids, the choice of drugs often requires a combination of clinical symptoms, serum specific antibodies, pathological results and response to initial treatment, and continuous adjustments during the treatment process. The purpose of this review is to provide an overview the drugs currently used in the treatment of JDM, observation of therapeutic effects and strategies for drug selection, and to provide ideas for clinical treatment.

Cite this article

Yanru Reviewer: SUN , Li Reviser: LIU . Drug treatment progress on juvenile dermatomyositis[J]. Journal of Clinical Pediatrics, 2022 , 40(5) : 395 -400 . DOI: 10.12372/jcp.2022.21e1485

References

[1] Gara S, Jamil RT, Muse ME, et al. Juvenile Dermatomyositis. (2022 Jan 25). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2022.
[2] Cattalini M, Soliani M, Caparello M C, et al. Sex Differences in Pediatric Rheumatology[J]. Clin Rev Allergy Immunol, 2019, 56(3): 293-307.
[3] 幼年皮肌炎诊治指南(专家建议)审议稿: 中华医学会小儿免疫学术会议[C], 中山, 2010.
[4] Giancane G, Lavarello C, Pistorio A, et al. The PRINTO evidence-based proposal for glucocorticoids tapering/discontinuation in new onset juvenile dermatomyositis patients[J]. Pediatr Rheumatol Online J, 2019, 17(1): 24.
[5] Glaubitz S, Zeng R, Schmidt J. New insights into the treatment of myositis[J]. Ther Adv Musculoskelet Dis, 2020, 12:1759720X19886494x.
[6] Ruperto N, Pistorio A, Oliveira S, et al. Prednisone versus prednisone plus ciclosporin versus prednisone plus methotrexate in new-onset juvenile dermatomyositis: a randomised trial[J]. Lancet, 2016, 387(10019): 671-678.
[7] Kohsaka H, Mimori T, Kanda T, et al. Treatment consensus for management of polymyositis and dermatomyositis among rheumatologists, neurologists and dermatologists[J]. J Dermatol, 2019, 46(1): e1-e18.
[8] 刘力, 孙艳茹, 胡坚. 幼年皮肌炎慢作用药物治疗进展[J]. 中国实用儿科杂志, 2021, 36(11): 839-842.
[9] 鲁卓林, 刘力, 孙燕燕. 氯喹和羟氯喹的应用进展[J]. 国际生物医学工程杂志, 2020. 43(4): 330-334.
[10] Kim S, Kahn P, Robinson AB, et al. Childhood Arthritis and Rheumatology Research Alliance consensus clinical treatment plans for juvenile dermatomyositis with skin predominant disease[J]. Pediatr Rheumatol Online J, 2017, 15(1): 1.
[11] Broen JCA, van Laar JM. Mycophenolate mofetil, azathioprine and tacrolimus: mechanisms in rheumatology[J]. Nat Rev Rheumatol, 2020, 16(3): 167-178.
[12] Hassan J, van der Net JJ, van Royen-Kerkhof A. Treatment of refractory juvenile dermatomyositis with tacrolimus[J]. Clin Rheumatol, 2008. 27(11): 1469-1471.
[13] Patel D, Wairkar S. Recent advances in cyclosporine drug delivery: challenges and opportunities[J]. Drug Deliv Transl Res, 2019, 9(6): 1067-1081.
[14] Huber AM. Update on the clinical management of juvenile dermatomyositis[J]. Expert Rev Clin Immunol, 2018, 14(12): 1021-1028.
[15] Huber AM, Giannini EH, Bowyer SL, et al. Protocols for the initial treatment of moderately severe juvenile dermatomyositis: results of a Children's Arthritis and Rheumatology Research Alliance Consensus Conference[J]. Arthritis Care Res (Hoboken). 2010, 62(2): 219-225.
[16] Liu K, Tomlinson G, Reed AM, et al. Pilot study of the juvenile dermatomyositis consensus treatment plans: A CARRA registry study[J]. J Rheumatol, 2021, 48(1): 114-122.
[17] Bader-Meunier B, Gitiaux C, Belot A, et al. French expert opinion for the management of juvenile dermatomyositis[J]. Arch Pediatr, 2019, 26(2): 120-125.
[18] Kurtzman DJB, Vleugels RA. Anti-melanoma differentiation-associated gene 5 (MDA5) dermatomyositis: A concise review with an emphasis on distinctive clinical features[J]. J Am Acad Dermatol, 2018, 78(4): 776-785.
[19] Bellutti Enders F, Bader-Meunier B, Baildam E, et al. Consensus-based recommendations for the management of juvenile dermatomyositis[J]. Ann Rheum Dis, 2017, 76(2): 329-340.
[20] Cobos GA, Femia A, Vleugels RA. Dermatomyositis: An update on diagnosis and treatment[J]. Am J Clin Dermatol, 2020, 21(3): 339-353.
[21] Deakin CT, Campanilho-Marques R, Simou S, et al. Efficacy and Safety of Cyclophosphamide Treatment in Severe Juvenile Dermatomyositis Shown by Marginal Structural Modeling[J]. Arthritis Rheumatol, 2018, 70(5): 785-793.
[22] Fujisawa T. Management of Myositis-Associated Interstitial Lung Disease[J]. Medicina (Kaunas), 2021, 57(4): 347.
[23] Hassan J, van der Net JJ, van Royen-Kerkhof A. Treatment of refractory juvenile dermatomyositis with tacrolimus[J]. Clin Rheumatol, 2008, 27(11): 1469-1471.
[24] Sasaki H, Kohsaka H. Current diagnosis and treatment of polymyositis and dermatomyositis[J]. Mod Rheumatol, 2018, 28(6): 913-921.
[25] Oddis CV, Reed AM, Aggarwal R, et al. Rituximab in the treatment of refractory adult and juvenile dermatomyositis and adult polymyositis: a randomized, placebo-phase trial[J]. Arthritis Rheum, 2013, 65(2): 314-324.
[26] Varnier GC, Pilkington CA, Wedderburn LR. Juvenile dermatomyositis: novel treatment approaches and outcomes[J]. Curr Opin Rheumatol, 2018, 30(6): 650-654.
[27] Riley P, McCann LJ, Maillard SM, et al. Effectiveness of infliximab in the treatment of refractory juvenile dermatomyositis with calcinosis[J]. Rheumatology (Oxford), 2008, 47(6): 877-880.
[28] Takata M, Yamasaki A, Yamada N, et al. A case of clinically amyopathic dermatomyositis that developed during anti-TNF-α therapy for rheumatoid arthritis[J]. Allergol Int, 2018, 67(2): 286-288.
[29] Lyakhovitsky A, Warshavsky K, Rozner L, et al. Dermatomyositis-lupuslike syndrome overlap under treatment with etanercept for rheumatoid arthritis[J]. JAAD Case Rep, 2020, 6(8): 758-760.
[30] Sukumaran S, Vijayan V. Abatacept in the treatment of juvenile dermatomyositis-associated calcifications in a 16-year-old girl[J]. Case Rep Rheumatol, 2020, 2020: 4073879.
[31] Tjärnlund A, Tang Q, Wick C, et al. Abatacept in the treatment of adult dermatomyositis and polymyositis: a randomised, phase IIb treatment delayed-start trial[J]. Ann Rheum Dis, 2018, 77(1): 55-62.
[32] Voyer TL, Gitlaux C, Authier FJ, et al. JAK inhibitors are effective in a subset of patients with juvenile dermatomyositis: a monocentric retrospective study[J]. Rheumatology (Oxford), 202160(12): 5801-5808.
[33] Moneta GM, Pires Marafon D, Marasco E, et al. Muscle expression of type Ⅰ and type Ⅱ interferons is increased in juvenile dermatomyositis and related to clinical and histologic features[J]. Arthritis Rheumatol, 2019, 71(6): 1011-1021.
[34] Higgs BW, Zhu W, Morehouse C, et al. A phase 1b clinical trial evaluating sifalimumab, an anti-IFN-α monoclonal antibody, shows target neutralisation of a type I IFN signature in blood of dermatomyositis and polymyositis patients[J]. Ann Rheum Dis, 2014, 73(1): 256-262.
[35] Pachman LM, Khojah AM. Advances in juvenile dermatomyositis: myositis specific antibodies aid in understanding disease heterogeneity[J]. J Pediatr, 2018, 195: 16-27.
Outlines

/