An exploration of the role of second-line treatments in resistant forms of juvenile dermatomyositis

Conventional treatments for juvenile dermatomyositis (corticoids, methotrexate, immunoglobulins) are sometimes ineffective and/or poorly tolerated. More recent molecules can then be proposed. A survey of 121 health professionals, mostly paediatricians and rheumatologists practising in the United States, revealed the following observations

  • half of the prescribers waited an average of four months before considering a second-line treatment,
  • among these new molecules, rituximab is clearly preferred by prescribers over abatacept, tocilizumab and infliximab,
  • the “seniority” of the practitioner does not modify practices.

The results of this survey will be used to establish national recommendations in a field where comparative studies are few and statistical evidence of efficacy is limited.


Treatment escalation patterns to start biologics in refractory moderate juvenile dermatomyositis among members of the Childhood Arthritis and Rheumatology Research Alliance. Sherman MA, Kim H, Banschbach K, et al. Pediatr Rheumatol Online J. 2023 Jan 6;21(1):3.