Mycophenolate mofetil: A possible therapeutic agent for children with juvenile dermatomyositis

Rouster‐Stevens, Kelly; Morgan, Gabrielle; Wang, Deli; Pachman, Lauren M.

doi:10.1002/acr.20269

Cited by 84 publications

(44 citation statements)

References 38 publications

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“…A retrospective review of 50 JDM patients treated with MMF for 12 months showed significant improvement in the validated disease activity scores for skin and muscle, as well as a decrease in mean prednisone dosage [19]. The infection rate 12 months before and after drug initiation was assessed in a subset of 26 children with JDM and showed no signs of increasing with use of MMF.…”

Section: Intravenous Immunoglobulinmentioning

confidence: 97%

Therapeutic Approaches in Myositis

Aggarwal

Oddis

2011

Curr Rheumatol Rep

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The inflammatory myopathies are a heterogeneous group of diseases including dermatomyositis, polymyositis, and inclusion body myositis. Few clinical trials have been conducted in myositis, making it difficult to provide clear recommendations on the treatment of these rare disorders. Although corticosteroids have not been tested in randomized controlled trials, the general expert consensus confirms their first-line use. However, in many patients, corticosteroid toxicity leads to significant disability, or these agents are ineffective, which then requires additional immunosuppression. Intravenous immunoglobulin is a reasonable short-term treatment with proven benefit in a controlled trial, but its long-term effectiveness remains unknown. The evidence for other immunosuppressive therapies has been derived mainly from case reports and open studies. These agents include methotrexate and/or azathioprine, followed by cyclosporine or tacrolimus (particularly for antisynthetase antibody-positive patients) and mycophenolate mofetil (for refractory rash). Newer therapies (eg, rituximab) are encouraging, but results from the largest randomized controlled trial studying this agent are soon to follow. The balance of evidence suggests that immunosuppressive drugs are effective in dermatomyositis and polymyositis, although randomized controlled trials are lacking.

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Section: Intravenous Immunoglobulinmentioning

confidence: 97%

Therapeutic Approaches in Myositis

Aggarwal

Oddis

2011

Curr Rheumatol Rep

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“…In a retrospective trial of 50 children with JDM treated with mycophenolate mofetil, Disease Activity Score improved and prednisone dose was decreased after 12 months [46]. Systemic tacrolimus therapy was shown to improve refractory skin disease as well as overall disease activity in a case series of three children with JDM [47].…”

Section: Other Agentsmentioning

confidence: 97%

Juvenile Dermatomyositis

Batthish

Feldman

2011

Curr Rheumatol Rep

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“…Two retrospective studies where 12 [73] and 50 [74] JDM patients were treated with MMF demonstrated a good response and safety profile. It is usually given at starting dose of 600mg/m 2 /day, then can be increased to 1200mg/m 2 /day divided in two doses if well tolerated.…”

Section: Mycophenolate Mofetil (Mmf)mentioning

confidence: 99%

Treatment of Juvenile Dermatomyositis: An Update

Papadopoulou

Wedderburn

2017

Pediatr Drugs

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Abstract:The Idiopathic Inflammatory Myopathies of childhood consist a heterogeneous group of autoimmune diseases characterised by proximal muscle weakness and pathognomonic skin rashes. The overall prognosis of juvenile myositis has improved significantly over recent years, but the long-term outcome differs substantially from patient to patient suggestive of distinct clinical phenotypes with variable responses to treatment. High doses of corticosteroids remain the cornerstone of therapy along with other immunosuppressant therapies depending on disease severity and response. The advent of biological drugs has revolutionised the management of various paediatric rheumatologic diseases, including inflammatory myopathies. There are few data from randomised controlled trials to guide management decisions, thus several algorithms for the treatment of juvenile myositis have been developed using international expert opinion. The general treatment goals now include elimination of active disease and normalization of physical function, so as to preserve normal growth and development, and to prevent long-term damage and deformities. This review summarizes the newer and possible future therapies of juvenile inflammatory myopathies, including evidence supporting their efficacy and safety.

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Mycophenolate mofetil: A possible therapeutic agent for children with juvenile dermatomyositis

Cited by 84 publications

References 38 publications

Therapeutic Approaches in Myositis

Therapeutic Approaches in Myositis

Juvenile Dermatomyositis

Treatment of Juvenile Dermatomyositis: An Update

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