Childhood Arthritis and Rheumatology Research Alliance consensus clinical treatment plans for juvenile dermatomyositis with skin predominant disease

Susan Kim; Philip Kahn; Angela B. Robinson; Bianca Lang; Andrew Shulman; Edward J. Oberle; Kenneth Schikler; Megan Lea Curran; Lilliana Barillas-Arias; Charles H. Spencer; Lisa G. Rider; Adam M. Huber

doi:10.1186/s12969-016-0134-0

Childhood Arthritis and Rheumatology Research Alliance consensus clinical treatment plans for juvenile dermatomyositis with skin predominant disease

Susan Kim^*, Philip Kahn, Angela B. Robinson, Bianca Lang, Andrew Shulman, Edward J. Oberle, Kenneth Schikler, Megan Lea Curran, Lilliana Barillas-Arias, Charles H. Spencer, Lisa G. Rider, Adam M. Huber

^*Corresponding author for this work

Pediatrics

Research output: Contribution to journal › Article › peer-review

63 Scopus citations

Abstract

Background: Juvenile dermatomyositis (JDM) is the most common form of the idiopathic inflammatory myopathies in children. A subset of children have the rash of JDM without significant weakness, and the optimal treatments for these children are unknown. The goal of this study was to describe the development of consensus clinical treatment plans (CTPs) for children with JDM who have active skin rashes, without significant muscle involvement, referred to as skin predominant JDM in this manuscript. Methods: The Children's Arthritis and Rheumatology Research Alliance (CARRA) is a North American consortium of pediatric rheumatology health care providers. CARRA members collaborated to determine consensus on typical treatments for JDM patients with skin findings without significant weakness, to develop CTPs for this subgroup of patients. We used a combination of Delphi surveys and nominal group consensus meetings to develop these CTPs. Results: Consensus was reached on patient characteristics and outcome assessment, and CTPs were developed and finalized for patients with skin predominant JDM. Treatment option A included hydroxychloroquine alone, Treatment option B included hydroxychloroquine and methotrexate, and Treatment option C included hydroxychloroquine, methotrexate and corticosteroids. Conclusions: Three CTPs were developed for use in children with skin predominant JDM, which reflect typical treatment approaches. These are not considered to be specific recommendations or standard of care. Using the CARRA network and prospective data collection, we will be able to apply statistical methods in the future to allow comparisons of JDM patients following these consensus treatment plans.

Original language	English (US)
Article number	1
Journal	Pediatric Rheumatology
Volume	15
Issue number	1
DOIs	https://doi.org/10.1186/s12969-016-0134-0
State	Published - Jan 11 2017

Funding

CARRA is supported in part by grants from the Arthritis Foundation, NIAMS, Duke Clinical Research Institute, the WASIE Foundation, and CureJM. Dr. Rider is supported in part by the intramural research program of the National Institutes of Health, National Institute of Environmental Health Sciences. We thank Dr. Alison Ehrlich for critical reading of the manuscript. We also would like to thank our PeDRA collaborators and Dermatology Colleagues who helped to review and distribute the survey, including Dr. Shielagh Maguiness, Dr. Ruth Ann Vleugels, Dr. Jennifer Huang, Dr. Yvonne Chiu, Dr. Michele Ramien, Dr. Jérôme Coulombe, MD, Dr. Regina-Celeste Ahmad, Dr. Lisa M. Arkin and Dr. Reagan Hunt. Mitali Dave is acknowledged for her insights and contribution as a parent of a child with JDM to our CTP development, as well as Dr. Fatma Dedeoglu, Dr. Andrew Eichenfield, Dr. Donald Goldsmith, Dr. Peri Pepmueller, Dr. Kathryn Phillippi, Dr. Kara Schmidt, Dr. Rosie Scuccimarri and Dr. Amy Woodward were active participants in the development of this CTP.

Keywords

Adolescent
Amyopathic
Child
Dermatomyositis, Childhood Type
Therapeutics

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Rheumatology
Immunology and Allergy

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10.1186/s12969-016-0134-0

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Kim, S., Kahn, P., Robinson, A. B., Lang, B., Shulman, A., Oberle, E. J., Schikler, K., Curran, M. L., Barillas-Arias, L., Spencer, C. H., Rider, L. G., & Huber, A. M. (2017). Childhood Arthritis and Rheumatology Research Alliance consensus clinical treatment plans for juvenile dermatomyositis with skin predominant disease. Pediatric Rheumatology, 15(1), Article 1. https://doi.org/10.1186/s12969-016-0134-0

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title = "Childhood Arthritis and Rheumatology Research Alliance consensus clinical treatment plans for juvenile dermatomyositis with skin predominant disease",

abstract = "Background: Juvenile dermatomyositis (JDM) is the most common form of the idiopathic inflammatory myopathies in children. A subset of children have the rash of JDM without significant weakness, and the optimal treatments for these children are unknown. The goal of this study was to describe the development of consensus clinical treatment plans (CTPs) for children with JDM who have active skin rashes, without significant muscle involvement, referred to as skin predominant JDM in this manuscript. Methods: The Children's Arthritis and Rheumatology Research Alliance (CARRA) is a North American consortium of pediatric rheumatology health care providers. CARRA members collaborated to determine consensus on typical treatments for JDM patients with skin findings without significant weakness, to develop CTPs for this subgroup of patients. We used a combination of Delphi surveys and nominal group consensus meetings to develop these CTPs. Results: Consensus was reached on patient characteristics and outcome assessment, and CTPs were developed and finalized for patients with skin predominant JDM. Treatment option A included hydroxychloroquine alone, Treatment option B included hydroxychloroquine and methotrexate, and Treatment option C included hydroxychloroquine, methotrexate and corticosteroids. Conclusions: Three CTPs were developed for use in children with skin predominant JDM, which reflect typical treatment approaches. These are not considered to be specific recommendations or standard of care. Using the CARRA network and prospective data collection, we will be able to apply statistical methods in the future to allow comparisons of JDM patients following these consensus treatment plans.",

keywords = "Adolescent, Amyopathic, Child, Dermatomyositis, Childhood Type, Therapeutics",

author = "Susan Kim and Philip Kahn and Robinson, {Angela B.} and Bianca Lang and Andrew Shulman and Oberle, {Edward J.} and Kenneth Schikler and Curran, {Megan Lea} and Lilliana Barillas-Arias and Spencer, {Charles H.} and Rider, {Lisa G.} and Huber, {Adam M.}",

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year = "2017",

month = jan,

day = "11",

doi = "10.1186/s12969-016-0134-0",

language = "English (US)",

volume = "15",

journal = "Pediatric Rheumatology",

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Kim, S, Kahn, P, Robinson, AB, Lang, B, Shulman, A, Oberle, EJ, Schikler, K, Curran, ML, Barillas-Arias, L, Spencer, CH, Rider, LG & Huber, AM 2017, 'Childhood Arthritis and Rheumatology Research Alliance consensus clinical treatment plans for juvenile dermatomyositis with skin predominant disease', Pediatric Rheumatology, vol. 15, no. 1, 1. https://doi.org/10.1186/s12969-016-0134-0

TY - JOUR

T1 - Childhood Arthritis and Rheumatology Research Alliance consensus clinical treatment plans for juvenile dermatomyositis with skin predominant disease

AU - Kim, Susan

AU - Kahn, Philip

AU - Robinson, Angela B.

AU - Lang, Bianca

AU - Shulman, Andrew

AU - Oberle, Edward J.

AU - Schikler, Kenneth

AU - Curran, Megan Lea

AU - Barillas-Arias, Lilliana

AU - Spencer, Charles H.

AU - Rider, Lisa G.

AU - Huber, Adam M.

PY - 2017/1/11

Y1 - 2017/1/11

N2 - Background: Juvenile dermatomyositis (JDM) is the most common form of the idiopathic inflammatory myopathies in children. A subset of children have the rash of JDM without significant weakness, and the optimal treatments for these children are unknown. The goal of this study was to describe the development of consensus clinical treatment plans (CTPs) for children with JDM who have active skin rashes, without significant muscle involvement, referred to as skin predominant JDM in this manuscript. Methods: The Children's Arthritis and Rheumatology Research Alliance (CARRA) is a North American consortium of pediatric rheumatology health care providers. CARRA members collaborated to determine consensus on typical treatments for JDM patients with skin findings without significant weakness, to develop CTPs for this subgroup of patients. We used a combination of Delphi surveys and nominal group consensus meetings to develop these CTPs. Results: Consensus was reached on patient characteristics and outcome assessment, and CTPs were developed and finalized for patients with skin predominant JDM. Treatment option A included hydroxychloroquine alone, Treatment option B included hydroxychloroquine and methotrexate, and Treatment option C included hydroxychloroquine, methotrexate and corticosteroids. Conclusions: Three CTPs were developed for use in children with skin predominant JDM, which reflect typical treatment approaches. These are not considered to be specific recommendations or standard of care. Using the CARRA network and prospective data collection, we will be able to apply statistical methods in the future to allow comparisons of JDM patients following these consensus treatment plans.

AB - Background: Juvenile dermatomyositis (JDM) is the most common form of the idiopathic inflammatory myopathies in children. A subset of children have the rash of JDM without significant weakness, and the optimal treatments for these children are unknown. The goal of this study was to describe the development of consensus clinical treatment plans (CTPs) for children with JDM who have active skin rashes, without significant muscle involvement, referred to as skin predominant JDM in this manuscript. Methods: The Children's Arthritis and Rheumatology Research Alliance (CARRA) is a North American consortium of pediatric rheumatology health care providers. CARRA members collaborated to determine consensus on typical treatments for JDM patients with skin findings without significant weakness, to develop CTPs for this subgroup of patients. We used a combination of Delphi surveys and nominal group consensus meetings to develop these CTPs. Results: Consensus was reached on patient characteristics and outcome assessment, and CTPs were developed and finalized for patients with skin predominant JDM. Treatment option A included hydroxychloroquine alone, Treatment option B included hydroxychloroquine and methotrexate, and Treatment option C included hydroxychloroquine, methotrexate and corticosteroids. Conclusions: Three CTPs were developed for use in children with skin predominant JDM, which reflect typical treatment approaches. These are not considered to be specific recommendations or standard of care. Using the CARRA network and prospective data collection, we will be able to apply statistical methods in the future to allow comparisons of JDM patients following these consensus treatment plans.

KW - Adolescent

KW - Amyopathic

KW - Child

KW - Dermatomyositis, Childhood Type

KW - Therapeutics

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Childhood Arthritis and Rheumatology Research Alliance consensus clinical treatment plans for juvenile dermatomyositis with skin predominant disease

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