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Differences in therapeutic approach to juvenile dermatomyositis between Europe and Latin America

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Pediatric Rheumatology20086 (Suppl 1) :P214

https://doi.org/10.1186/1546-0096-6-S1-P214

  • Published:

Keywords

  • Muscle Damage
  • Great Frequency
  • Study Visit
  • Dermatomyositis
  • Gender Ratio

Objective

To investigate the differences in the therapeutic approach to juvenile dermatomyositis (JDM) between pediatric rheumatology centers in Europe (EU) and Latin America (LA).

Methods

490 patients with JDM and disease duration > 2 years seen in 27 centers in EU (Italy, UK) and LA (Argentina, Brazil, Mexico) after 1980 were enrolled in a multinational, multicenter study aimed to investigate the long-term disease outcome. Median follow-up duration was 7.7 years (range 2–25.2 years). Gender ratio, onset age, and follow-up duration were comparable between EU and LA patients. At study visit, EU patients had a greater frequency of active disease, as measured with MDAA (51.1% vs. 35.2%) and DAS (64.8% vs. 54%), whereas LA patients had a greater frequency of muscle weakness, as measured with the CMAS (62.9% vs. 44.3%), and muscle damage, as measured with the MDI (41% vs. 30.1%).

Results

Table 1 shows the frequency of drugs administered to JDM patients in EU and LA centers.
Table 1

Frequency of drugs administered to JDM patients in EU and LA centers

 

Oral/iv steroids

Pulse iv steroids

MTX

CyA

Iv Ig

AM

AZA

Oral CPM

Pulse iv CPM

EU (N = 246)

97.6

50

50.8

35

17.1

26

13.4

5.3

8.5

LA (N = 236)

99.6

33.2

61.4

15.7

17.4

39

5.9

2.1

4.2

MTX: methotrexate; CyA: cyclosporine A; AM: antimalarials; AZA: azathioprine; CPM: cyclophosphamide

Conclusion

Use of pulse iv steroids, CyA, AZA and CPM was more common in EU centers, whereas LA centers used more frequently MTX and AM. EU and LA centers administered iv Ig with equal frequency.

Authors’ Affiliations

(1)
Italian Pediatric Rheumatology Study Group, Italy, Italy
(2)
Hospital General de Ninos Pedro de Elizalde, Buenos Aires, Argentina
(3)
Hospital Garrahan, Buenos Aires, Argentina
(4)
Hospital Pequeno Principe, Curitiba, Brazil
(5)
Hospital da Universidade, Ribeirao Preto, Brazil
(6)
Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
(7)
Hospital das Clínicas UNESP, Botucatu, Brazil
(8)
Hospital Das Clinicas, Sao Paulo, Brazil
(9)
CMN Siglo XXI, Mexico City, Mexico
(10)
Hospital General de México, Mexico City, Mexico
(11)
CMN La Raza, Mexico City, Mexico
(12)
Great Ormond Street Hospital, London, UK

Copyright

© Trail et al; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd.

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