Immunobiologics in juvenile dermatomyositis: a systematic review of promising therapeutic advances.

IF 1.7 Q3 RHEUMATOLOGY

Reumatologia Pub Date : 2024-01-01 Epub Date: 2024-12-24 DOI:10.5114/reum/195799

Aline Maria de Oliveira Rocha, Gabriel Fidelis Ribeiro, Juliana Capecce Silva

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Abstract

Introduction: To identify the most effective treatment for juvenile dermatomyositis (JDM), considering efficacy, safety, impact on patients and improvement in their quality of life.

Material and methods: A systematic review was carried out comparing known treatments and immunobiological therapies, evaluating clinical improvement, adverse events and prognosis. The MEDLINE, PubMed, LILACS and Cochrane Library databases were used with children aged 0 to 18 diagnosed with JDM. The PRISMA 2020 statement was followed throughout the process.

Results: The immunobiologics studied were rituximab (RTX) and anti-tumor necrosis factor drugs and used the Disease Activity Score to skin, Childhood Myositis Assessment Scale and Manual Muscle Testing tools. There was no difference in the response when RTX was used (early or late). The anti-TNF studies were carried out in a population that was refractory to the initial treatment and showed a significant improvement in muscle and skin disease activity.

Conclusions: For severe or refractory disease, biologics tend to be the medication with the best therapeutic response.

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免疫生物制剂在青少年皮肌炎：有前途的治疗进展的系统回顾。

目的：综合考虑疗效、安全性、对患者的影响以及对患者生活质量的改善，确定青少年皮肌炎（JDM）最有效的治疗方法。材料和方法：系统回顾比较已知治疗方法和免疫生物学治疗方法，评估临床改善、不良事件和预后。MEDLINE, PubMed， LILACS和Cochrane图书馆数据库用于诊断为JDM的0至18岁儿童。整个过程遵循了PRISMA 2020声明。结果：研究的免疫生物学药物为利妥昔单抗（RTX）和抗肿瘤坏死因子药物，使用皮肤疾病活动度评分、儿童肌炎评估量表和手工肌肉测试工具。当使用RTX（早期或晚期）时，反应没有差异。抗肿瘤坏死因子研究是在对初始治疗难治的人群中进行的，并显示肌肉和皮肤疾病活动有显着改善。结论：对于严重或难治性疾病，生物制剂往往是治疗效果最好的药物。

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