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Cyclosporin in juvenile dermatomyositis
J Heckmatt1, N Hasson, C Saunders
1Department of Paediatrics, Hammersmith Hospital, London.
Lancet (London, England)
|May 13, 1989
Summary
Cyclosporin effectively treated juvenile dermatomyositis in children resistant to steroids. This immunosuppressant improved muscle function and resolved complications, allowing for reduced steroid use with minimal side effects.
Area of Science:
- Pediatric Rheumatology
- Immunology
Background:
- Juvenile dermatomyositis (JDM) is a rare autoimmune disease affecting children.
- Steroids and other immunosuppressants are standard treatments but may be insufficient for some patients.
- Chronic active JDM can lead to serious complications and prolonged disability.
Observation:
- Fourteen children with chronic active JDM, unresponsive to conventional therapies, were treated with cyclosporin.
- These patients had an average disease duration of 3 years.
- Twelve patients experienced significant complications from JDM or prior treatments.
Findings:
- Cyclosporin treatment led to successful outcomes in all fourteen children.
- Patients showed recovery of muscle strength and improved functional capacity.
- Complications of the disease and previous treatments resolved with cyclosporin therapy.
- Steroid dosage was reduced or discontinued in all patients, a previously challenging goal.
- Low cyclosporin doses (2.5-7.5 mg/kg daily) were effective.
- No serious adverse events were reported during cyclosporin treatment.
Implications:
- Cyclosporin offers a viable and safe treatment option for refractory juvenile dermatomyositis.
- This approach can improve patient outcomes and quality of life.
- Reducing steroid dependence mitigates long-term treatment side effects.