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Oral immunosuppressive medications, including corticosteroids and methotrexate, are standard therapy for children (and adults) with dermatomyositis. Using biologic agents as possible steroid- and immunosuppressive-sparing agents is reasonable, as the believed mechanism of disease involves inflammatory mediators. Results are mixed in case reports and small case series examining tumor necrosis factor (TNF) antagonist therapy.
Investigators prospectively enrolled nine patients with refractory juvenile dermatomyositis (JDMS) in an open-label, 12-week trial of 0.4 mg/kg etanercept twice-weekly (the dosage used for juvenile arthritis). Etanercept was added to existing therapies, including methotrexate in all patients and oral or IV corticosteroids…