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The PRINTO criteria for clinically inactive disease in juvenile dermatomyositis.

Publication ,  Journal Article
Lazarevic, D; Pistorio, A; Palmisani, E; Miettunen, P; Ravelli, A; Pilkington, C; Wulffraat, NM; Malattia, C; Garay, SM; Hofer, M; Quartier, P ...
Published in: Ann Rheum Dis
May 2013

OBJECTIVES: To develop data-driven criteria for clinically inactive disease on and off therapy for juvenile dermatomyositis (JDM). METHODS: The Paediatric Rheumatology International Trials Organisation (PRINTO) database contains 275 patients with active JDM evaluated prospectively up to 24 months. Thirty-eight patients off therapy at 24 months were defined as clinically inactive and included in the reference group. These were compared with a random sample of 76 patients who had active disease at study baseline. Individual measures of muscle strength/endurance, muscle enzymes, physician's and parent's global disease activity/damage evaluations, inactive disease criteria derived from the literature and other ad hoc criteria were evaluated for sensitivity, specificity and Cohen's κ agreement. RESULTS: The individual measures that best characterised inactive disease (sensitivity and specificity >0.8 and Cohen's κ >0.8) were manual muscle testing (MMT) ≥78, physician global assessment of muscle activity=0, physician global assessment of overall disease activity (PhyGloVAS) ≤0.2, Childhood Myositis Assessment Scale (CMAS) ≥48, Disease Activity Score ≤3 and Myositis Disease Activity Assessment Visual Analogue Scale ≤0.2. The best combination of variables to classify a patient as being in a state of inactive disease on or off therapy is at least three of four of the following criteria: creatine kinase ≤150, CMAS ≥48, MMT ≥78 and PhyGloVAS ≤0.2. After 24 months, 30/31 patients (96.8%) were inactive off therapy and 69/145 (47.6%) were inactive on therapy. CONCLUSION: PRINTO established data-driven criteria with clearly evidence-based cut-off values to identify JDM patients with clinically inactive disease. These criteria can be used in clinical trials, in research and in clinical practice.

Duke Scholars

Published In

Ann Rheum Dis

DOI

EISSN

1468-2060

Publication Date

May 2013

Volume

72

Issue

5

Start / End Page

686 / 693

Location

England

Related Subject Headings

  • Sensitivity and Specificity
  • Rheumatology
  • Reference Standards
  • Randomized Controlled Trials as Topic
  • Prospective Studies
  • Male
  • Longitudinal Studies
  • Immunosuppressive Agents
  • Humans
  • Follow-Up Studies
 

Citation

APA
Chicago
ICMJE
MLA
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Lazarevic, D., Pistorio, A., Palmisani, E., Miettunen, P., Ravelli, A., Pilkington, C., … Paediatric Rheumatology International Trials Organisation (PRINTO), . (2013). The PRINTO criteria for clinically inactive disease in juvenile dermatomyositis. Ann Rheum Dis, 72(5), 686–693. https://doi.org/10.1136/annrheumdis-2012-201483
Lazarevic, Dragana, Angela Pistorio, Elena Palmisani, Paivi Miettunen, Angelo Ravelli, Clarissa Pilkington, Nico M. Wulffraat, et al. “The PRINTO criteria for clinically inactive disease in juvenile dermatomyositis.Ann Rheum Dis 72, no. 5 (May 2013): 686–93. https://doi.org/10.1136/annrheumdis-2012-201483.
Lazarevic D, Pistorio A, Palmisani E, Miettunen P, Ravelli A, Pilkington C, et al. The PRINTO criteria for clinically inactive disease in juvenile dermatomyositis. Ann Rheum Dis. 2013 May;72(5):686–93.
Lazarevic, Dragana, et al. “The PRINTO criteria for clinically inactive disease in juvenile dermatomyositis.Ann Rheum Dis, vol. 72, no. 5, May 2013, pp. 686–93. Pubmed, doi:10.1136/annrheumdis-2012-201483.
Lazarevic D, Pistorio A, Palmisani E, Miettunen P, Ravelli A, Pilkington C, Wulffraat NM, Malattia C, Garay SM, Hofer M, Quartier P, Dolezalova P, Penades IC, Ferriani VPL, Ganser G, Kasapcopur O, Melo-Gomes JA, Reed AM, Wierzbowska M, Rider LG, Martini A, Ruperto N, Paediatric Rheumatology International Trials Organisation (PRINTO). The PRINTO criteria for clinically inactive disease in juvenile dermatomyositis. Ann Rheum Dis. 2013 May;72(5):686–693.

Published In

Ann Rheum Dis

DOI

EISSN

1468-2060

Publication Date

May 2013

Volume

72

Issue

5

Start / End Page

686 / 693

Location

England

Related Subject Headings

  • Sensitivity and Specificity
  • Rheumatology
  • Reference Standards
  • Randomized Controlled Trials as Topic
  • Prospective Studies
  • Male
  • Longitudinal Studies
  • Immunosuppressive Agents
  • Humans
  • Follow-Up Studies