18 वर्ष से कम आयु के बच्चों में प्रमुख अंग भागीदारी के बिना जुवेनाइल डर्मेटोमायोसाइटिस का उपचार

References

1. For patients with severe disease (such as major organ involvement/extensive ulcerative skin disease), addition of intravenous cyclophosphamide should be considered.
2. We recommend the induction regimen for treatment of new onset patients with JDM to be based on high dose of corticosteroids (oral or intravenous) combined with MTX.
3. High-dose corticosteroids should be administered systemically either orally or intravenously in moderate–severe JDM.
4. MTX should be started at a dose of 15–20 mg/m²/week (max absolute dose of 40 mg/week) preferably administered subcutaneously at disease onset.
5. Addition of MTX or ciclosporin A leads to better disease control than prednisolone alone; safety profiles favour the combination of methotrexate and prednisolone.
6. In patients who are intolerant to methotrexate, change to another DMARD, including ciclosporin A or MMF.
7. If a newly diagnosed patient has inadequate response to treatment, intensification of treatment should be considered within the first 12 weeks, after consultation with an expert centre.
8. In 2012, PRINTO published criteria defining clinically inactive disease; necessitating fulfilment of three out of four variables from CPK ≤150 U/L, CMAS ≥48, MMT8 ≥78 and PGA score of overall disease activity ≤0.2.

DOI: 10.1136/annrheumdis-2016-209247