Potential New Treatment for Patients with Juvenile Dermatomyositis

A tumor necrosis factor inhibitor (anti-TNF) could be a possible new treatment for patients with juvenile dermatomyositis (JDM) who failed to respond to previous treatments, according to a study presented at the European League Against Rheumatism Annual Congress.

JDM is an autoimmune disease that causes inflammation of the muscles, skin, and other organs that result in skin rash, skin ulceration, and muscle weakness. Increased mortality and complications are more likely to be seen in patients who do not respond to treatments compared with those who do.

"High levels of the cell signaling protein TNF have been reported in JDM patients with a long disease course, suggesting this immune cell regulator may play a significant role in refractory disease," said researcher Raquel Campanilho-Marques, MD, MSc. "There are no published clinical trials (only case reports) of this therapy, but some are in progress. Our study is one of the largest to explore the efficacy and safety of anti-TNF therapy in a large independent cohort of JDM patients."

There were 66 patients with JDM included in the study who were treated with anti-TNF agents. These patients showed improvements in muscle and skin involvement and in disease activity, according to the study.

However, researchers did find that approximately one-quarter of patients switched their treatment. Approximately two-thirds of those patients switched due to no response from therapy, one-quarter switched due to adverse effects, and one-eighth switched to receive subcutaneous administration.

Researchers found 7 severe adverse effects. Of the mild-to-moderate adverse effects, researchers found three-quarters were a result of infection, but temporarily withholding the drug was effective, the study concluded.