OBJECTIVE: We surveyed pediatric rheumatologists (PR) in North America to learn how they treat pediatric localized scleroderma (LS), a disease associated with significant morbidity for the growing child. METHODS: A Web-based survey was sent to the 195 PR members of the pediatric rheumatology research alliance CARRA (Childhood Arthritis and Rheumatology Research Alliance). Members were asked which medications they use to treat LS and which factors modify their treatment strategies. Clinical vignettes were provided to learn the specific treatment regimens used. RESULTS: A total of 158 PR from over 70 clinical centers in the United States and Canada participated in the survey, representing 81% of the CARRA membership. These PR saw over 650 patients with LS in the prior year. Nearly all respondents treated LS with methotrexate (MTX) and corticosteroids; most of them intensify treatment for lesions located on the face or near a joint, and about half intensify treatment for recent disease onset (< 6 months). Most PR reserve topical medications for limited treatment situations. Clinical vignettes showed that PR use a broad range of treatment doses and durations for MTX and corticosteroids. CONCLUSION: Most PR in North America treat localized scleroderma with a combination of MTX and corticosteroids. However, there is no consensus on specific treatment regimens. There is a need for controlled treatment trials to better determine optimal therapy for this potentially disabling disease.
OBJECTIVE: We surveyed pediatric rheumatologists (PR) in North America to learn how they treat pediatric localized scleroderma (LS), a disease associated with significant morbidity for the growing child. METHODS: A Web-based survey was sent to the 195 PR members of the pediatric rheumatology research alliance CARRA (Childhood Arthritis and Rheumatology Research Alliance). Members were asked which medications they use to treat LS and which factors modify their treatment strategies. Clinical vignettes were provided to learn the specific treatment regimens used. RESULTS: A total of 158 PR from over 70 clinical centers in the United States and Canada participated in the survey, representing 81% of the CARRA membership. These PR saw over 650 patients with LS in the prior year. Nearly all respondents treated LS with methotrexate (MTX) and corticosteroids; most of them intensify treatment for lesions located on the face or near a joint, and about half intensify treatment for recent disease onset (< 6 months). Most PR reserve topical medications for limited treatment situations. Clinical vignettes showed that PR use a broad range of treatment doses and durations for MTX and corticosteroids. CONCLUSION: Most PR in North America treat localized scleroderma with a combination of MTX and corticosteroids. However, there is no consensus on specific treatment regimens. There is a need for controlled treatment trials to better determine optimal therapy for this potentially disabling disease.
Authors: Han Jie Soh; Courtney Samuel; Victoria Heaton; William Douglas Renton; Angela Cox; Jane Munro Journal: Rheumatol Int Date: 2019-03-05 Impact factor: 2.631
Authors: Suzanne C Li; Kathryn S Torok; Elena Pope; Fatma Dedeoglu; Sandy Hong; Heidi T Jacobe; C Egla Rabinovich; Ronald M Laxer; Gloria C Higgins; Polly J Ferguson; Andrew Lasky; Kevin Baszis; Mara Becker; Sarah Campillo; Victoria Cartwright; Michael Cidon; Christi J Inman; Rita Jerath; Kathleen M O'Neil; Sheetal Vora; Andrew Zeft; Carol A Wallace; Norman T Ilowite; Robert C Fuhlbrigge Journal: Arthritis Care Res (Hoboken) Date: 2012-08 Impact factor: 4.794
Authors: Tamás Constantin; Ivan Foeldvari; Clare E Pain; Annamária Pálinkás; Peter Höger; Monika Moll; Dana Nemkova; Lisa Weibel; Melinda Laczkovszki; Philip Clements; Kathryn S Torok Journal: Eur J Pediatr Date: 2018-05-04 Impact factor: 3.183