Comparing Three Drug Regimens for Juvenile Dermatomyositis

Juvenile onset of dermatomyositis is associated with risk for permanent muscle loss, weakness, and the possibility of calcinosis if not treated early. Previous reports have suggested that high doses of prednisone or pulses of intravenous methylprednisolone might reduce the frequency of calcinosis. In addition, most authorities feel that the addition of an immunosuppressive agent is steroid sparing. Whether the immunosuppressive agent should be initiated at diagnosis or after failed response to corticosteroids and which might be the most effective and safest agent are unknown.

These authors performed a randomized study at multiple medical centers of three regimens: prednisone 2 mg/kg/day alone; prednisone plus methotrexate 15–20 mg/m² weekly …