. Author manuscript; available in PMC: 2010 Oct 1.

Published in final edited form as: Best Pract Res Clin Rheumatol. 2009 Oct;23(5):665–678. doi: 10.1016/j.berh.2009.07.007

Table 3.

Therapeutic Options for Juvenile Dermatmoyositis^*

First Line Therapies^*
Prednisone 1-2 mg/kg/day po
Intravenous Methylprednisolone 10-30 mg/kg/pulse
Methotrexate 0.4 - 1 mg/kg/week, or 15 mg/m²
Adjunctive therapies: Hydroxychloroquine 3 – 6 mg/kg/day po
Physical therapy
Photoprotective measures
Topical therapies for skin rashes
Calcium and vitamin D for bone protection

Second Line Therapies
Intravenous gammaglobulin 1- 2 gm/kg/month
Cyclosporine 2.5 – 7.5 mg/kg/day po divided bid
Azathioprine 3 -5 mg/kg/day
Combinations of the above

Third Line Therapies
Cyclophosphamide 500-1250 mg/m²/month intravenous pulse
Mycophenolate Mofetil 30-40 mg/kg/day po divided bd
Tacrolimus 0.1-0.25 mg/kg/day po divided bd
Rituximab
Anti-tumor necrosis factor alpha agents
Combinations of the above

treatment of JDM, whereas second and third-line therapies are most often used in the Agents as first-line therapies are among those most often used in the initial treatment of refractory patients, patients considered to have severe features, or patients with unacceptable medication toxicities, that are supported by at least one publication in patients with JDM. The order in which therapies or combinations of therapies are used is not implied by the listing in this table.