Evidence map›Paper›PMID 28610606›Full record

ArticlePediatric rheumatology online journal2017

Biologic therapies for refractory juvenile dermatomyositis: five years of experience of the Childhood Arthritis and Rheumatology Research Alliance in North America.

C H Spencer, K Rouster-Stevens, H Gewanter, G Syverson, R Modica, K Schmidt, H Emery, C Wallace, S Grevich, K Nanda and 28 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric rheumatology online journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
4.1field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 53 citations in OpenAlex.

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  13. Treatment of Calcinosis in Juvenile Dermatomyositis.Current rheumatology reports · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

38 authors at 20 institutions in 2 countries.

C H SpencerNationwide Children's Hospital and Ohio State University, Columbus, OH, USA. spencercharlesh1@gmail.com.
K Rouster-StevensEmory University School of Medicine, Atlanta, GA, USA.
H GewanterPediatric and Adolescent Health Partners, Richmond, VA, USA.
G SyversonUniversity of Wisconsin-Madison, Madison, WI, USA.
R ModicaUniversity of Florida, Gainesville, FL, USA.
K SchmidtUniversity of Louisville, Louisville, KY, USA.
H EmerySeattle Children's Hospital, University of Washington, Seattle, WA, USA.
C WallaceSeattle Children's Hospital, University of Washington, Seattle, WA, USA.
S GrevichSeattle Children's Hospital, University of Washington, Seattle, WA, USA.
K NandaSeattle Children's Hospital, University of Washington, Seattle, WA, USA.
Y D ZhaoSeattle Children's Hospital, University of Washington, Seattle, WA, USA.
S ShenoiSeattle Children's Hospital, University of Washington, Seattle, WA, USA.
S TarvinRiley Hospital for Children, Indiana University Medical Center, Indianapolis, IN, India.
S HongUniversity of Iowa Health Care, Iowa City, IA, USA.
C LindsleyUniversity of Kansas Medical Center, Kansas City, KS, USA.
J E WeissSanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ, USA.
M PassoUniversity of South Carolina, Charleston, SC, USA.
K EdePhoenix Children's Hospital, Phoenix, AZ, USA.
A BrownTexas Children's Hospital, Houston, TX, USA.
K ArdalanLurie Children's Hospital, Chicago, IL, USA.
W BernalUniversity of California, San Francisco, San Francisco, CA, USA.
M L StollUniversity of Alabama at Birmingham, Birmingham, AL, USA.
B LangWK Health Center and Dalhousie University, Halifax, NS, Canada.
R CarrascoDell Children's Hospital, Austin, TX, USA.
C AgaiarChildren's Hospital of The Kings Daughter, Norfolk, VA, USA.
L FellerInland Rheumatology, Waterville, ME, USA.
H BukulmezMetro Health Medical Center and Case Western Reserve University, Cleveland, OH, USA.
R VeheUniversity of Minnesota, Minneapolis, MN, USA.
H KimNational Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.
H SchmelingAlberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
D GerstbacherLucille Packard Children's Hospital, Stanford University, Stanford, CA, USA.
M HoeltzelMott Children's Hospital, University of Michigan, Ann Arbor, MI, USA.
B EberhardCohen Children's Medical Center of New York, New york, USA.
R SundelBoston Children's Hospital and Harvard Medical School, Boston, MA, USA.
S KimUniversity of California, San Francisco, San Francisco, CA, USA.
A M HuberWK Health Center and Dalhousie University, Halifax, NS, Canada.
A PatwardhanSchool of Medicine, University of Missouri, Columbia, MO, USA.
Pediatric Rheumatologist Collaborators
Seattle Children's Hospital · USDalhousie University · CABoston Children's Hospital · USChildren's Hospital of The King's Daughters · USHackensack University Medical Center · USLucile Packard Children's Hospital · USLurie Children's Hospital · USNational Institutes of Health · USNationwide Children's Hospital · USUniversity of Wisconsin–Madison · USEmory University · USMetroHealth Medical Center · USPhoenix Children's Hospital · USRiley Hospital for Children · USUniversity of California, San Francisco · USUniversity of Kansas Medical Center · USUniversity of Louisville · USUniversity of Michigan · USUniversity of Minnesota · USUniversity of Missouri · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe prognosis of children with juvenile dermatomyositis (JDM) has improved remarkably since the 1960's with the use of corticosteroid and immunosuppressive therapy. Yet there remain a minority of children who have refractory disease. Since 2003 the sporadic use of biologics (genetically-engineered proteins that usually are derived from human genes) for inflammatory myositis has been reported. In 2011-2016 we investigated our collective experience of biologics in JDM through the Childhood Arthritis and Rheumatology Research Alliance (CARRA).

methodsThe JDM biologic study group developed a survey on the CARRA member experience using biologics for Juvenile DM utilizing Delphi consensus methods in 2011-2012. The survey was completed online by the CARRA members interested in JDM in 2012. A second survey was similarly developed that provided more opportunity to describe their experiences with biologics in JDM in detail and was completed by CARRA members in Feb 2013. During three CARRA meetings in 2013-2015, nominal group techniques were used for achieving consensus on the current choices of biologic drugs. A final survey was performed at the 2016 CARRA meeting.

resultsOne hundred and five of a potential 231 pediatric rheumatologists (42%) responded to the first survey in 2012. Thirty-five of 90 had never used a biologic for Juvenile DM at that time. Fifty-five of 91 (denominators vary) had used biologics for JDM in their practice with 32%, 5%, and 4% using rituximab, etanercept, and infliximab, respectively, and 17% having used more than one of the three drugs. Ten percent used a biologic as monotherapy, 19% a biologic in combination with methotrexate (mtx), 52% a biologic in combination with mtx and corticosteroids, 42% a combination of a biologic, mtx, corticosteroids (steroids), and an immunosuppressive drug, and 43% a combination of a biologic, IVIG and mtx. The results of the second survey supported these findings in considerably more detail with multiple combinations of drugs used with biologics and supported the use of rituximab, abatacept, anti-TNFα drugs, and tocilizumab in that order. One hundred percent recommended that CARRA continue studying biologics for JDM. The CARRA meeting survey in 2016 again supported the study and use of these four biologic drug groups.

conclusionsOur CARRA JDM biologic work group developed and performed three surveys demonstrating that pediatric rheumatologists in North America have been using multiple biologics for refractory JDM in numerous scenarios from 2011 to 2016. These survey results and our consensus meetings determined our choice of four biologic therapies (rituximab, abatacept, tocilizumab and anti-TNFα drugs) to consider for refractory JDM treatment when indicated and to evaluate for comparative effectiveness and safety in the future. Significance and Innovations This is the first report that provides a substantial clinical experience of a large group of pediatric rheumatologists with biologics for refractory JDM over five years. This experience with biologic therapies for refractory JDM may aid pediatric rheumatologists in the current treatment of these children and form a basis for further clinical research into the comparative effectiveness and safety of biologics for refractory JDM.

Indexed as

DermatomyositisDrug Therapy, CombinationAntirheumatic AgentsBiological TherapyChildDisease ResistanceEtanerceptFemaleGlucocorticoidsHumansInfliximabMaleMedication Therapy ManagementMethotrexatePediatricsPractice Patterns, Physicians'Antirheumatic AgentsEtanerceptGlucocorticoidsInfliximabMethotrexateRituximab

Identifiers

PMID28610606
PMCPMC5470177
OpenAlexW2626024150

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.