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Table 3 Treatment targets and treatment strategy

From: Development of practice and consensus-based strategies including a treat-to-target approach for the management of moderate and severe juvenile dermatomyositis in Germany and Austria

Statements

Consensus

Treatment targets

100%

The overall goal is clinical inactive disease within 1 year after initiation of therapy, ideally under a glucocorticoid-free treatment regimen. Under some circumstances, low-dose glucocorticoids or intermittent intravenous methylprednisolone pulse therapy may be acceptable.

The following interim improvementa is targeted:

• At least a moderate improvement within 6 weeks after initiation or substantial change in therapy.

• At least a major improvement within 3 months after initiation or substantial change in therapy.

General treatment strategy

92%

The consensus treatment strategies for JDM serve to harmonize existing therapies in clinical practice.

The treatment strategy generally consists of a treat-to-target strategy, i.e. therapies are modified according to reaching or failing previously established targets. In addition, there is a more intensive first (induction) treatment phase (6–8 weeks) and a less intensive subsequent (maintenance) phase.

Components of the initial therapy include glucocorticoids and glucocorticoid-sparing DMARDs.

  1. a American College of Rheumatology/European League Against Rheumatism criteria (categories: no, minimal, moderate, major improvement) [34]