Methotrexate treatment of recalcitrant childhood dermatomyositis
Version of Record online: 16 APR 2008
Copyright © 1992 American College of Rheumatology
Arthritis & Rheumatism
Volume 35, Issue 10, pages 1143–1149, October 1992
How to Cite
Miller, L. C., Sisson, B. A., Tucker, L. B., Denardo, B. A. and Schaller, J. G. (1992), Methotrexate treatment of recalcitrant childhood dermatomyositis. Arthritis & Rheumatism, 35: 1143–1149. doi: 10.1002/art.1780351006
- Issue online: 16 APR 2008
- Version of Record online: 16 APR 2008
- Manuscript Accepted: 12 MAY 1992
- Manuscript Received: 2 JAN 1992
- Bureau of Maternal and Child Health. Grant Number: MCJ-255064
Objective. To review the clinical course of 16 children with recalcitrant dermatomyositis (DM), who were treated with oral methotrexate (MTX) in addition to prednisone.
Methods. Sixteen patients with recalcitrant DM who were treated with MTX in addition to prednisone were followed between 1984 and 1990. The patients' clinical responses to treatment, including alterations in muscle strength and muscle enzyme levels, changes in prednisone dosage, and development of toxicity or complications were reviewed retrospectively.
Results. All 12 patients who received MTX for at least 8 months regained normal muscle strength. In 11 of the 12, the prednisone dosage could eventually be tapered to ⩽5 mg/day. Complications during MTX treatment required discontinuation of MTX in 5 patients, and were unrelated to the cumulative dose of the drug. Active disease recurred in 5 patients in whom MTX had been discontinued after apparent clinical remission had been achieved.
Conclusion. MTX, in combination with prednisone, is a useful adjunct in the treatment of recalcitrant childhood DM. However, recurrence of disease after withdrawal of MTX suggests that the drug may have a suppressive, rather than a remittive, effect.