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REVIEW PAPER
Immunobiologics in juvenile dermatomyositis: a systematic review of promising therapeutic advances
1
Department of Pediatric, Federal University of São Paulo, Brazil
2
University Center São Camilo, Brazil
Submission date: 2024-08-14
Final revision date: 2024-10-24
Acceptance date: 2024-11-10
Publication date: 2024-12-24
Corresponding author
Aline Maria de Oliveira Rocha
Federal University of São Paulo, University Center São Camilo, Nazare St., 1501 – Ipiranga, São Paulo – SP, zipcode 04263-200, Brazil
Federal University of São Paulo, University Center São Camilo, Nazare St., 1501 – Ipiranga, São Paulo – SP, zipcode 04263-200, Brazil
Reumatologia 2024;62(6):447-455
KEYWORDS
TOPICS
Scleroderma, myositis and related syndromes - aetiology, pathogenesis, clinical features and treatmentAssessment of disease activity and quality of life in rheumatic diseasesNew therapies in rheumatic diseasesHealth care problems
ABSTRACT
Introduction:
To identify the most effective treatment for juvenile dermatomyositis (JDM), considering efficacy, safety, impact on patients and improvement in their quality of life.
Material and Methods:
A systematic review was carried out comparing known treatments and immunobiological therapies, evaluating clinical improvement, adverse events and prognosis. The MEDLINE, PubMed, LILACS and Cochrane Library databases were used with children aged 0 to 18 diagnosed with JDM. The PRISMA 2020 statement was followed throughout the process.
Results:
The immunobiologics studied were rituximab (RTX) and anti-tumor necrosis factor drugs and used the Disease Activity Score to skin, Childhood Myositis Assessment Scale and Manual Muscle Testing tools. There was no difference in the response when RTX was used (early or late). The anti-TNF studies were carried out in a population that was refractory to the initial treatment and showed a significant improvement in muscle and skin disease activity.
Conclusions:
For severe or refractory disease, biologics tend to be the medication with the best therapeutic response.
To identify the most effective treatment for juvenile dermatomyositis (JDM), considering efficacy, safety, impact on patients and improvement in their quality of life.
Material and Methods:
A systematic review was carried out comparing known treatments and immunobiological therapies, evaluating clinical improvement, adverse events and prognosis. The MEDLINE, PubMed, LILACS and Cochrane Library databases were used with children aged 0 to 18 diagnosed with JDM. The PRISMA 2020 statement was followed throughout the process.
Results:
The immunobiologics studied were rituximab (RTX) and anti-tumor necrosis factor drugs and used the Disease Activity Score to skin, Childhood Myositis Assessment Scale and Manual Muscle Testing tools. There was no difference in the response when RTX was used (early or late). The anti-TNF studies were carried out in a population that was refractory to the initial treatment and showed a significant improvement in muscle and skin disease activity.
Conclusions:
For severe or refractory disease, biologics tend to be the medication with the best therapeutic response.
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Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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