Clinical characteristics of children with juvenile dermatomyositis: the Childhood Arthritis and Rheumatology Research Alliance Registry.

Journal Article (Journal Article;Multicenter Study)

OBJECTIVE: To investigate aspects of juvenile dermatomyositis (DM), including disease characteristics and treatment, through a national multicenter registry. METHODS: Subjects meeting the modified Bohan and Peter criteria for definite juvenile DM were analyzed from the cross-sectional Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry between 2010 and 2012 from 55 US pediatric rheumatology centers. Demographics, disease characteristics, diagnostic assessments, and medication exposure data were collected at enrollment. RESULTS: A total of 384 subjects met the criteria for analysis. At enrollment, the median Childhood Myositis Assessment Scale score was 51 (interquartile range [IQR] 46-52), the median Childhood Health Assessment Questionnaire score was 0 (IQR 0-0.5), and the median physician and subject global assessment scores were 1 (IQR 0-2) and 1 (IQR 0-3), respectively, out of a maximum of 10. Of the diagnostic assessments, magnetic resonance imaging was more likely than electromyography or muscle biopsy to show abnormalities. A total of 329 subjects had ≥2 diagnostic studies performed, and >34% of these subjects reported ≥1 negative study. Ninety-five percent had been treated with corticosteroids and 92% with methotrexate, suggesting that these medications were almost universally prescribed for juvenile DM in the US. CONCLUSION: In 2 years, the ongoing CARRA Registry has collected clinical data on 384 children with juvenile DM and has the potential to become one of the largest juvenile DM cohorts in the world. More research is needed about prognostic factors in juvenile DM, and differences in therapy based on manifestations of disease need to be explored by practitioners. This registry provides the infrastructure needed to advance clinical and translational research and represents a major step toward improving outcomes of children with juvenile DM.

Full Text

Duke Authors

Cited Authors

  • Robinson, AB; Hoeltzel, MF; Wahezi, DM; Becker, ML; Kessler, EA; Schmeling, H; Carrasco, R; Huber, AM; Feldman, BM; Reed, AM; Juvenile Myositis CARRA Subgroup, for the CARRA Registry Investigators,

Published Date

  • March 2014

Published In

Volume / Issue

  • 66 / 3

Start / End Page

  • 404 - 410

PubMed ID

  • 23983017

Pubmed Central ID

  • PMC4078654

Electronic International Standard Serial Number (EISSN)

  • 2151-4658

Digital Object Identifier (DOI)

  • 10.1002/acr.22142


  • eng

Conference Location

  • United States