Evidence map›Paper›PMID 40410052›Full record

GuidelineAnnals of the rheumatic diseases2025

Treating juvenile dermatomyositis to target: Paediatric Rheumatology European Society/Childhood Arthritis and Rheumatology Research Alliance-endorsed recommendations from an international task force.

Angelo Ravelli, Silvia Rosina, Jayne M MacMahon, Talia Baird, Ana Isabel Rebollo-Giménez, Claas Hinze, Liza J McCann, Ann M Reed, Lisa G Rider, Matilde Arvigo and 31 more

Abstract readPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Annals of the rheumatic diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

41 authors.

Angelo RavelliDirezione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genoa, Italy. Electronic address: angeloravelli@gaslini.org.
Silvia RosinaUOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Jayne M MacMahonDivision of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences (CHES), SickKids Research Institute, Toronto, Ontario, Canada.
Talia BairdDivision of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Ana Isabel Rebollo-GiménezDepartment of Rheumatology, Hospital General Universitario Gregorio Marañón University Hospital, Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain.
Claas HinzeDepartment of Pediatric Rheumatology and Immunology, University Hospital Münster, Münster, Germany.
Liza J McCannDepartment of Paediatric Rheumatology, Institute in the Park, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom; Department of Women and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom.
Ann M ReedDepartment of Pediatrics, Duke University, Durham, NC, USA.
Lisa G RiderEnvironmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, MD, USA.
Matilde ArvigoPatient representative.
Brigitte Bader-MeunierDepartment of Paediatric Hematology-Immunology and Rheumatology, Necker-Enfants Malades Hospital, AP-HP, Paris, France; National Reference Centre for Inflammatory Diseases and Pediatric Rheumatology - Immunology, Hematology and Pediatric Rheumatology Unit, Université Paris-Cité, IMAGINE Institute, Necker Children's Hospital, Paris, France.
Claudio BrunoDepartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genoa, Italy; Division of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Li CaifengDepartment of Rheumatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Raquel Campanilho-MarquesPediatric Rheumatology Unit, Pediatric and Rheumatology Department, Lisbon Academic Medical Center, Lisbon, Portugal.
Sara CuccatoPatient representative.
Chiara FiorilloDepartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genoa, Italy; Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.
Nikki A HahnParent representative; Cure JM Foundation representative.
Adam M HuberIWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
Marc JansenDepartment of Paediatric Rheumatology and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands.
Ozgur KasapcopurDepartment of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Maria Martha KatsikasServicio de Inmunología y Reumatología, Hospital Nacional de Pediatría Juan P. Garrahan, Buenos Aires, Argentina.
Susan KimDivision of Pediatric Rheumatology, Department of Pediatrics, University of California, San Francisco, CA, USA.
Polly LivermoreRheumatology Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
Sue MaillardDepartment of Paediatric Rheumatology, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom.
Clara MalattiaDepartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genoa, Italy; UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Angela Nyangore MigowaDepartment of Paediatrics and Child Health, Aga Khan University Medical College East Africa, Nairobi, Kenya.
Takako MiyamaeDepartment of Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Ruth MurphyUniversity of Sheffield and Sheffield University Teaching Hospitals, Sheffield, United Kingdom.
Rebecca NicolaiDivision of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy.
Charalampia PapadopoulouPaediatric Rheumatology Department, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom; Inflammation and Rheumatology Section, University College London Great Ormond Street Institute of Child Health, London, United Kingdom.
Clarissa PilkingtonBlood, Cells and Cancer, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom.
Helga SannerDepartment of Rheumatology, Oslo University Hospital, Oslo, Norway; Department of Health Sciences, Oslo New University College, Oslo, Norway.
Sujata SawhneyDivision of Pediatric Rheumatology, Institute of Child Health, Sir Ganga Ram Hospital, New Delhi, India.
Elzbieta SmolewskaDepartment of Paediatric Cardiology and Rheumatology, Medical University of Lodz, Lodz, Poland.
Stacey E TarvinDivision of Rheumatology, Riley Hospital for Children at Indiana University School of Medicine, Indianapolis, IN, USA.
Georgina TillerDivision of Paediatric Rheumatology, The Royal Children's Hospital, Melbourne, Australia; Division of Paediatric Rheumatology, Monash Children's Hospital, Melbourne, Australia.
Natasa ToplakDepartment of Allergology, Rheumatology and Clinical Immunology, UCH, UMC Ljubljana, Medical Faculty, Ljubljana, Slovenia.
Lucy R WedderburnInfection, Immunity and Inflammation Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom; NIHR Biomedical Research Centre, Great Ormond Street Hospital, London, United Kingdom; Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCL Hospital and Great Ormond Street Hospital, London, United Kingdom.
Francesca BovisDepartment of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
Alessandro ConsolaroDepartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genoa, Italy; UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Brian M FeldmanDivision of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Departments of Pediatrics, Medicine, Faculty of Medicine, and Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.

Funding

Assessment, Therapy and Prevention Of Autoimmune DiseaseZIAES101081 · NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES · 2025 to 2025
$1.4M
Intramural NIH HHS ZIA ES101081
6 · The paper itself

Abstract

objectivesDespite the recent prognostic improvement, a sizeable proportion of patients with juvenile dermatomyositis (JDM) respond suboptimally to contemporary therapies. This study aimed to develop recommendations for treating JDM to target.

methodsA Steering Committee formulated a set of provisional recommendations based on evidence derived from a systematic literature review and a retrospective chart review of patients. These were discussed, amended, and voted on by an international Task Force, including 28 paediatric rheumatologists, 2 specialists in neuromuscular diseases, 1 dermatologist, 1 physical therapist, 1 research nurse, 2 patients with JDM, and 1 parent of a patient with JDM. Items that achieved at least an 80% majority vote were accepted as final recommendations.

resultsAlthough the literature review did not reveal trials that compared a treat-to-target strategy with a nonsteered approach, it provided indirect evidence about specific end points that could serve as targets that facilitated development of recommendations. The group reached consensus on 7 overarching principles and 12 recommendations. It was agreed that both patients/parents and treaters should share decisions in setting treatment targets and therapeutic strategies, with inactive disease as the preferred target and minimal disease activity an alternative one. Inactive disease is targeted to be achieved within 12 months after treatment start. Interim targets include minimal and moderate clinical improvement within 6 weeks and 3 months, respectively, and normalisation of muscle strength within 6 months. High-dose glucocorticoids remain fundamental in the initial management, but progressive tapering and discontinuation within 12 months through optimisation of concomitant immunomodulatory therapy was advised. A research agenda was formulated.

conclusionsThe Task Force developed recommendations for treating JDM to target, being aware that the evidence is not strong and needs to be expanded by future research. Implementation of the recommendations in clinical practice will help to reach optimal outcomes for JDM.

Indexed as

DermatomyositisAdolescentAdvisory CommitteesAntirheumatic AgentsChildConsensusGlucocorticoidsHumansRheumatologySocieties, MedicalSystematic Reviews as TopicAntirheumatic AgentsGlucocorticoids

Identifiers

PMID40410052
PMCPMC12229752

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.