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KISHI Takayuki
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Assistant Professor |
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| Article types | Original article |
| Language | English |
| Peer review | Peer reviewed |
| Title | Corticosteroid discontinuation, complete clinical response and remission in juvenile dermatomyositis. |
| Journal | Formal name：Rheumatology (Oxford, England) Abbreviation：Rheumatology (Oxford) ISSN code：14620332/14620324 |
| Domestic / Foregin | Foregin |
| Volume, Issue, Page | 60(5),pp.2134-2145 |
| Author and coauthor | Kishi Takayuki, Warren-Hicks William, Bayat Nastaran, Targoff Ira N, Huber Adam M, Ward Michael M, Rider Lisa G, |
| Authorship | Lead author |
| Publication date | 2021/05 |
| Summary | OBJECTIVE:A North American registry of JDM patients was examined for frequency of and factors associated with corticosteroid discontinuation, complete clinical response and remission.METHODS:We evaluated probability of achieving final corticosteroid discontinuation, complete clinical response and remission in 307 JDM patients by Weibull time-to-event modelling; conditional probability of complete clinical response and remission using Bayesian network modelling; and significant predictors with multivariable Markov chain Monte-Carlo Weibull extension models.RESULTS:The probability of corticosteroid discontinuation was 56%, complete clinical response 38% and remission 30% by 60 months after initial treatment in 105 patients. The probability of remission was conditional on corticosteroid discontinuation and complete clinical response. Photosensitivity, contractures and a longer time to complete clinical response were predictive of the time to final corticosteroid discontinuation. Anti-MJ (NXP2) autoantibodies and a Northwest residential geoclimatic zone were predictive of shorter time to complete clinical response, while dysphonia, contractures, an increase in medications within 24 months and a longer time to corticosteroid discontinuation were associated with longer time to complete clinical response. Anti-p155/140 (TIF1) autoantibodies, an increase in medications within 12-24 months, or longer times to corticosteroid discontinuation and complete clinical response were associated with longer time to remission.CONCLUSION:JDM patients achieve favourable outcomes, including corticosteroid discontinuation, complete clinical response and remission, although timelines for these may be several years based on time-dependent analyses. These outcomes are inter-related and strong predictors of each other. Selected clinical features and myositis autoantibodies are additionally associated with these outcomes. |
| DOI | 10.1093/rheumatology/keaa371 |
| PMID | 33067611 |