Anthropometric Effects of Intravenous Methylprednisolone Versus Oral Corticosteroids in the Treatment of Juvenile Dermatomyositis
Received Date: August 18, 2019; Published Date: August 27, 2019
Background: Oral corticosteroids (OCS) and intravenous methylprednisolone (IVMP) remain the backbone of therapeutic intervention for juvenile dermatomyositis (JDM).
Methods:We analyzed anthropometric (height, weight, and BMI) data, including percentile measures from growth charts, along with resolution of functional disability, as measured by the modified Rankin scale (MRS), to determine differences in effects between OCS or IVMP treatment.
Results:Over a 15-year period, 25 JDM patients had complete or near-complete resolution of symptoms and returned to baseline function based on MRS. Within groups, increases in weight and BMI percentiles were only significant in the OCS group (p = 0.009 and 0.011, respectively). Between groups, pretreatment height (p = 0.031), and posttreatment weight (p = 0.048) and BMI (p = 0.048) were significantly different. Percentile changes post- and pretreatment compared to 50th percentile weight for given height and age, along with changes based on a 50th percentile agematched individual were likely to be lower for the IVMP group as compared to the OCS group (p = 0.008 and 0.028, respectively).
ConclusionBoth OCS and IVMP resolved symptomology, but the results suggest that IVMP had a less significant negative impact on growth measures.
Keywords: Juvenile dermatomyositis (JDM); Corticosteroids (OCS); Anthropometry; Modified Rankin scale; Pulse intravenous methylprednisolone (IVMP)
Abbreviations:BMD: Bone Mineral Densit; BMI: Body Mass Index; CHAQ: Childhood Health Assessment Questionnaire; CI: 95% Confidence Interval; DAS: Disease Activity Score; IQR: Interquartile Range; IVIG: Intravenous Igg Immunoglobulin; IVMP: Intravenous Methylprednisolone; JDM: Juvenile Dermatomyositis; KOSCHI: King’s Outcome Score For Childhood Head Injury; Mrs: Modified Rankin Scale; MTX: Methotrexate; OCS: Oral Corticosteroids; P50 BMI: Value Of BMI for the 50th Percentile P50 Wt For Ht 50th Percentile Weight Given A Certain Height And Age; RCT: Randomized Control Trial; SD: Standard Deviation