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

Table 2 Consensus clinical treatment plans for Patients with Skin Predominant Juvenile Dermatomyositis*

All patients should be asked to use optimal sun protection, including regular use of broad spectrum sunscreen or sun block of SPF ≥ 30
All other topical therapies (steroids, calcineurin inhibitors, etc.) should be recorded
Treatment A
Hydroxychloroquine: 5mg/kg/day, maximum 400mg
Treatment B
Methotrexate subcutaneous, unless only oral administration is possible −15 mg/m² or 1 mg/kg (maximum 40 mg) once/week Hydroxychloroquine: 5mg/kg/day, maximum 400mg
Treatment C
Prednisone −1–2 mg/kg/day (maximum 60 mg) Methotrexate subcutaneous, unless only oral administration is possible −15 mg/m² or 1 mg/kg (maximum 40 mg) once/week Hydroxychloroquine: 5mg/kg/day, maximum 400mg

*Patients who develop weakness defined as need for additional disease-modifying antirheumatic drugs, or any of the following: decline in the MDAAT, MD Global, Extramuscular Disease Activity by ≥ 2cm or worsening of muscle enzymes by ≥20%. would be withdrawn from this CTP but may then be eligible to enter the CTPs for moderate JDM (13,14)

ISSN: 1546-0096