Long-term outcomes in juvenile dermatomyositis: how did we get here and where are we going?

Adam Huber, Brian M Feldman
Author Information
  1. Adam Huber: Division of Pediatric Rheumatology, IWK Health Centre, Halifax, Nova Scotia, Canada. adam.huber@iwk.nshealth.ca

Abstract

juvenile dermatomyositis (JDM) affects two to four children per million. Prior to treatment with corticosteroids, JDM had a high mortality rate (> 30%) and left 50% of those who survived with serious permanent impairments. After the introduction of corticosteroids, mortality rapidly dropped to less than 10%, and is currently reported to be less than 2% to 3%. Because most children now survive this illness, there is greater interest in long term outcomes. However, review of the literature shows while much is known about mortality, relatively little is known about long term outcomes such as physical function, quality of life, pain, educational and vocational achievement, patient satisfaction, and ongoing disease activity. Furthermore, the literature that has been published has not typically used the same outcomes making comparisons across studies difficult. Current efforts to identify key outcomes and validate measures for those outcomes will allow researchers in the future to provide this much needed information.

References

  1. J Rheumatol. 2003 May;30(5):1075-80 [PMID: 12734909]
  2. Rheum Dis Clin North Am. 2002 Nov;28(4):833-57 [PMID: 12506775]
  3. Rheumatology (Oxford). 2001 Nov;40(11):1262-73 [PMID: 11709610]
  4. Pediatr Clin North Am. 1995 Oct;42(5):1071-98 [PMID: 7567187]
  5. J Pediatr. 1980 Feb;96(2):226-34 [PMID: 6965409]
  6. Arthritis Rheum. 1999 Oct;42(10):2213-9 [PMID: 10524696]
  7. Am J Med. 1991 Aug;91(2):169-72 [PMID: 1714236]
  8. Pediatr Dermatol. 1985 Jul;2(4):275-81 [PMID: 4011505]
  9. Postgrad Med. 1954 Nov;16(5):396-404 [PMID: 13215194]
  10. Clin Exp Rheumatol. 1999 Jan-Feb;17(1):115-8 [PMID: 10084045]
  11. J Rheumatol. 1996 Aug;23(8):1424-7 [PMID: 8856623]
  12. Br J Rheumatol. 1995 Aug;34(8):732-6 [PMID: 7551657]
  13. Am J Dis Child. 1974 Apr;127(4):518-22 [PMID: 4821316]
  14. J Pediatr. 1972 Apr;80(4):555-63 [PMID: 5015065]
  15. J Rheumatol. 2001 May;28(5):1106-11 [PMID: 11361197]
  16. Arthritis Rheum. 1997 Nov;40(11):1976-83 [PMID: 9365086]
  17. J Pediatr. 1973 Oct;83(4):543-8 [PMID: 4729978]
  18. J Am Acad Dermatol. 2002 Oct;47(4):505-11 [PMID: 12271292]
  19. Pediatrics. 1953 Oct;12(4):447-66 [PMID: 13099915]
  20. Arthritis Rheum. 2002 Apr 15;47(2):118-23 [PMID: 11954004]
  21. Arthritis Rheum. 1977 Mar;20(2 Suppl):332-7 [PMID: 263909]
  22. Clin Pediatr (Phila). 1987 Nov;26(11):561-6 [PMID: 3665326]
  23. Rheumatology (Oxford). 2003 Dec;42(12):1452-9 [PMID: 12832713]
  24. J Rheumatol. 2001 Jan;28(1):192-7 [PMID: 11196524]
  25. J Rheumatol. 1995 Feb;22(2):326-31 [PMID: 7738957]
  26. Arthritis Rheum. 2004 May;50(5):1595-603 [PMID: 15146430]
  27. J Pediatr. 1983 Dec;103(6):882-8 [PMID: 6644423]
  28. AMA Arch Intern Med. 1957 Jul;100(1):70-6 [PMID: 13434509]
  29. Acta Med Scand Suppl. 1950;246:187-203 [PMID: 14789507]
  30. Arthritis Rheum. 1977 Mar;20(2 Suppl):327-31 [PMID: 263908]
  31. Can Med Assoc J. 1982 Jan 1;126(1):31-3 [PMID: 7059870]
  32. J Pediatr. 1984 Sep;105(3):399-408 [PMID: 6470862]
  33. J Am Acad Dermatol. 2001 Jul;45(1):28-34 [PMID: 11423831]
  34. Arch Dis Child. 1976 Jul;51(7):501-6 [PMID: 822785]
  35. Arthritis Rheum. 2003 Feb 15;49(1):7-15 [PMID: 12579588]
  36. J Rheumatol. 2001 Mar;28(3):610-5 [PMID: 11296968]
  37. Arthritis Rheum. 2005 Feb;52(2):601-7 [PMID: 15692974]
  38. Arch Dis Child. 1976 Jul;51(7):494-500 [PMID: 962360]
  39. Arthritis Rheum. 2003 Jun 15;49(3):300-5 [PMID: 12794783]
  40. Arch Dis Child. 1983 Jun;58(6):445-50 [PMID: 6859938]
  41. J Child Neurol. 1998 Mar;13(3):109-12 [PMID: 9535235]
  42. Arthritis Rheum. 2004 Jun 15;51(3):365-70 [PMID: 15188320]
  43. Arthritis Rheum. 2000 Mar;43(3):541-9 [PMID: 10728746]
  44. J Pediatr. 1964 Jan;64:101-31 [PMID: 14100086]
  45. South Med J. 1998 Jan;91(1):17-22 [PMID: 9438396]

MeSH Term

Adolescent
Adrenal Cortex Hormones
Child
Child, Preschool
Dermatomyositis
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Forecasting
Humans
Male
Prognosis
Quality of Life
Risk Assessment
Severity of Illness Index
Survival Rate
Treatment Outcome

Chemicals

Adrenal Cortex Hormones

Word Cloud

Created with Highcharts 10.0.0outcomesmortalityJDMchildrencorticosteroidslesslongtermliteraturemuchknownJuveniledermatomyositisaffectstwofourpermillionPriortreatmenthighrate>30%left50%survivedseriouspermanentimpairmentsintroductionrapidlydropped10%currentlyreported2%3%nowsurviveillnessgreaterinterestHoweverreviewshowsrelativelylittlephysicalfunctionqualitylifepaineducationalvocationalachievementpatientsatisfactionongoingdiseaseactivityFurthermorepublishedtypicallyusedmakingcomparisonsacrossstudiesdifficultCurrenteffortsidentifykeyvalidatemeasureswillallowresearchersfutureprovideneededinformationLong-termjuveniledermatomyositis:getgoing?

Similar Articles

Cited By (20)