Achieving Medication‐Free Remission in Patients With Juvenile Dermatomyositis
Objective Prognostic factors associated with medication discontinuation in children with juvenile dermatomyositis (JDM) remain largely elusive. We aim to identify the predictors of medication‐free remission (MFR) in children with JDM. Methods In this retrospective study, patients diagnosed with JDM...
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Wiley
2025-01-01
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| Series: | ACR Open Rheumatology |
| Online Access: | https://doi.org/10.1002/acr2.11751 |
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| author | Ilaria Maccora Hermine I. Brunner Amy Cassedy Mekibib Altaye Megan Quinlan‐Waters Daniel J. Lovell Alexei Grom Sheila T. Angeles‐Han |
| author_facet | Ilaria Maccora Hermine I. Brunner Amy Cassedy Mekibib Altaye Megan Quinlan‐Waters Daniel J. Lovell Alexei Grom Sheila T. Angeles‐Han |
| author_sort | Ilaria Maccora |
| collection | DOAJ |
| description | Objective Prognostic factors associated with medication discontinuation in children with juvenile dermatomyositis (JDM) remain largely elusive. We aim to identify the predictors of medication‐free remission (MFR) in children with JDM. Methods In this retrospective study, patients diagnosed with JDM according to Peter & Bohan criteria and followed for ≥18 months at a tertiary care center from 2006 through 2022 were included. Data extracted included demographics, physical examination, laboratory results, and medications. MFR was defined as inactive JDM after discontinuation of all systemic immunosuppressives for ≥6 months, in line with international consensus guidelines for trials of therapies in idiopathic inflammatory myopathies. A two‐sided P < 0.05 was considered statistically significant. Results Of 55 patients with JDM (63.6% female, age median [interquartile range (IQR)] 6 [3.5–12] years), 29 (52.7%) achieved MFR after a median (IQR) of 33 (22.5–55.2) months. MFR was more common in those who were younger at JDM diagnosis (median 5 vs 8 years, P = 0.008), had early resolution of disease activity (median 11 vs 18 months, P < 0.001), and presented with Gottron papules (χ2 = 5.25; P = 0.022) and elevated lactate dehydrogenase (χ2 = 4.82, P = 0.028). Diagnosis of JDM before 5 years old (odds ratio 4.5, 95% confidence interval [CI] 1.2–16.7) was the only predictor of MFR in our multivariate model (area under the curve 0.65, 95% CI 0.53–0.76). Conclusion Half of our patients with JDM achieved MFR. Age at JDM diagnosis may be an important predictor of achieving MFR. |
| format | Article |
| id | doaj-art-f52a2a384b5c41469f0e048ae5c6415e |
| institution | Kabale University |
| issn | 2578-5745 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | ACR Open Rheumatology |
| spelling | doaj-art-f52a2a384b5c41469f0e048ae5c6415e2025-02-04T06:21:23ZengWileyACR Open Rheumatology2578-57452025-01-0171n/an/a10.1002/acr2.11751Achieving Medication‐Free Remission in Patients With Juvenile DermatomyositisIlaria Maccora0Hermine I. Brunner1Amy Cassedy2Mekibib Altaye3Megan Quinlan‐Waters4Daniel J. Lovell5Alexei Grom6Sheila T. Angeles‐Han7Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, and University of Florence and Meyer Children's Hospital IRCCS Florence ItalyCincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine Cincinnati OhioCincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine Cincinnati OhioCincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine Cincinnati OhioCincinnati Children's Hospital Medical Center Cincinnati OhioCincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine Cincinnati OhioCincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine Cincinnati OhioCincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine Cincinnati OhioObjective Prognostic factors associated with medication discontinuation in children with juvenile dermatomyositis (JDM) remain largely elusive. We aim to identify the predictors of medication‐free remission (MFR) in children with JDM. Methods In this retrospective study, patients diagnosed with JDM according to Peter & Bohan criteria and followed for ≥18 months at a tertiary care center from 2006 through 2022 were included. Data extracted included demographics, physical examination, laboratory results, and medications. MFR was defined as inactive JDM after discontinuation of all systemic immunosuppressives for ≥6 months, in line with international consensus guidelines for trials of therapies in idiopathic inflammatory myopathies. A two‐sided P < 0.05 was considered statistically significant. Results Of 55 patients with JDM (63.6% female, age median [interquartile range (IQR)] 6 [3.5–12] years), 29 (52.7%) achieved MFR after a median (IQR) of 33 (22.5–55.2) months. MFR was more common in those who were younger at JDM diagnosis (median 5 vs 8 years, P = 0.008), had early resolution of disease activity (median 11 vs 18 months, P < 0.001), and presented with Gottron papules (χ2 = 5.25; P = 0.022) and elevated lactate dehydrogenase (χ2 = 4.82, P = 0.028). Diagnosis of JDM before 5 years old (odds ratio 4.5, 95% confidence interval [CI] 1.2–16.7) was the only predictor of MFR in our multivariate model (area under the curve 0.65, 95% CI 0.53–0.76). Conclusion Half of our patients with JDM achieved MFR. Age at JDM diagnosis may be an important predictor of achieving MFR.https://doi.org/10.1002/acr2.11751 |
| spellingShingle | Ilaria Maccora Hermine I. Brunner Amy Cassedy Mekibib Altaye Megan Quinlan‐Waters Daniel J. Lovell Alexei Grom Sheila T. Angeles‐Han Achieving Medication‐Free Remission in Patients With Juvenile Dermatomyositis ACR Open Rheumatology |
| title | Achieving Medication‐Free Remission in Patients With Juvenile Dermatomyositis |
| title_full | Achieving Medication‐Free Remission in Patients With Juvenile Dermatomyositis |
| title_fullStr | Achieving Medication‐Free Remission in Patients With Juvenile Dermatomyositis |
| title_full_unstemmed | Achieving Medication‐Free Remission in Patients With Juvenile Dermatomyositis |
| title_short | Achieving Medication‐Free Remission in Patients With Juvenile Dermatomyositis |
| title_sort | achieving medication free remission in patients with juvenile dermatomyositis |
| url | https://doi.org/10.1002/acr2.11751 |
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