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Clinical remission uncommon for cutaneous disease in dermatomyositis

Patients with clinically managed cutaneous dermatomyositis did not often enter remission even after aggressive treatment, according to recent findings.

The researchers evaluated the disease course of cutaneous dermatomyositis by conducting a prospective cohort study at a single tertiary referral center. The analysis included 74 patients seen between May 15, 2007, and Oct. 28, 2016.

Eligible participants included those with a baseline Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) activity score of 12 or higher, along with those who had two “or more CDASI scores separated by 3 months or more within their first 3 years of follow-up,” according to the researchers.

The primary outcome measure was the proportion of patients in clinical remission during the follow-up period.

Results showed that 38% of the cohort reached the primary endpoint.

There was a significant association between clinical remission and increased age (OR = 1.07; 95% CI, 1.02-1.12). Other factors significantly associated with the primary outcome measure included a dermatomyositis-associated malignancy (OR = 14.46; 95% CI, 2.18-96.07) and treatment with mycophenolate mofetil (OR = 6; 95% CI, 1.66-21.78).

In a time-to-event analysis, patients with anti–melanoma differentiation-associated protein 5 antibodies were significantly less likely to reach remission.

No significant associations with remission were reported with baseline cutaneous disease activity, disease duration at baseline, or disease duration prior to initiation of systemic treatment, according to the results.

“Clinical remission was relatively uncommon in our population despite aggressive systemic therapy, and patients with anti–melanoma differentiation associated protein 5 antibodies were even less likely to enter clinical remission during a 3-year follow-up period,” the researchers concluded. “Although mycophenolate mofetil compared favorably with other treatment options, our data provide evidence that a substantial population of patients with dermatomyositis have skin disease that is not adequately managed with standard-of-care therapies.” – by Rob Volansky

Disclosure: The authors report no relevant financial disclosures.