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JAMA Dermatology reports that clinical remission was relatively uncommon in dermatomyositis, despite aggressive systemic therapy, but was best in those receiving mycophenolate during a 3-year study.
Researchers from Stanford and Johns Hopkins did a prospective cohort study of 74 adults with dermatomyositis, and included those with a baseline Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) activity score of 12 or higher, and 2 or more CDASI scores separated by 3 months or more within their first 3 years of follow-up.
during a 3-year follow-up period, only 28 patients (38%) achieved clinical skin remission .
Factors associated with remission included:
- increasing age (OR 1.07; 95% CI, 1.02-1.12; P = .01)
- malignancy (OR, 14.46; 95% CI, 2.18-96.07; P = .01)
- mycophenolate mofetil therapy. (OR, 6.00; 95% CI, 1.66-21.78; P = .01)
Patients with MDA-5 (anti–melanoma differentiation-associated gene 5) antibodies tended to have the worse outcomes.
Baseline cutaneous disease activity, disease duration at baseline, and disease duration before first systemic therapy were not significantly associated with clinical remission of skin disease.