Review of Biologics in Children With Rheumatic Diseases

Shabina Habibi; Athimalaipet V Ramanan


Int J Clin Rheumatol. 2012;7(1):81-93. 

In This Article

Juvenile Dermatomyositis

Juvenile dermatomyositis is the most common inflammatory myositis of childhood, characterized by proximal muscle weakness and the pathognomonic rash, comprising Gottron's papules or heliotrope rash. Corticosteroid use has dramatically decreased the morbidity and mortality associated with the disease. However, up to 70% of patients show an incomplete response, including 10% who may be refractory to or relapse on corticosteroids.[77] These drugs are also associated with a variety of side effects, including weight gain, glucose intolerance, osteoporosis and cataracts. Although randomized controlled trials are lacking, drugs such as methotrexate, azathioprine, cyclosporine and more recently mycophenolate mofetil are often used as steroid-sparing agents. Although there are no randomized controlled trials on the use of rituximab in this disease, case series have reported the effectiveness and safety of this agent in the treatment of refractory disease.[78,79] Rituximab is administered at a dose of 375 mg/m2 weekly, for a total of four doses.


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