Treatment consensus for management of polymyositis and dermatomyositis among rheumatologists, neurologists and dermatologists

Abstract

Although rheumatologists, neurologists and dermatologists see patients with polymyositis (PM) and dermatomyositis (DM), their management appears to vary depending on the physician’s specialty. The aim of the present study was to establish the treatment consensus among specialists of the three fields to standardize the patient care. We formed a research team supported by a grant from the Ministry of Health, Labor and Welfare, Japan. Clinical questions (CQ) on the management of PM and DM were raised. A published work search on CQ was performed primarily using PubMed. Using the nominal group technique, qualified studies and results in the published work were evaluated and discussed to reach consensus recommendations. They were sent out to the Japan College of Rheumatology, Japanese Society of Neurology and Japanese Dermatological Association for their approval. We reached a consensus in 23 CQ and made recommendations and a decision tree for management was proposed. They were officially approved by the three scientific societies. In conclusion, a multidisciplinary treatment consensus for the management of PM and DM was established for the first time.

Keywords:

• consensus
• dermatomyositis
• management
• polymyositis
• treatment

Conflict of interest

H. K. has received consulting fees, speaking fees, honoraria and/or research grants from Astellas, Chugai, Japan Blood Products Organization, Mitsubishi-Tanabe, Pfizer, Ono, Bristol-Myers. T. M. has received research grants from Acterion, Astellas, Asahi Kasei Pharma, Ayumi, Chugai, Daiichi Sankyo, Eisai, JB, Mitsubishi Tanabe, MSD, Nippon Kayaku, Nippon Shinyaku, Pfizer, Sanofi and Takeda, and has participated in speakers’ bureaus for Bristol-Myers Squibb, Chugai and Mitsubishi-Tanabe. T. K. has received consulting fees, speaking fees, honoraria and/or research grants from Chugai, Novartis, Japan Blood Products Organization, Mitsubishi-Tanabe, Pfizer and Ono. J. S. has received speaking fees and/or honoraria from Japan Blood Products Organization. Y. S. has received research grants from Otsuka, Eisai, Daiichi Sankyo, Teijin Pharma, Sumitomo Dainippon Pharma and Takeda. M. F. has received research grants from Astellas, Novartis, Japan Blood Products Organization, Mitsubishi-Tanabe, Pfizer, Ono Pharma, Shionogi, Bristrol-Myyers Squibb, Maruho, Torii Phama and Kyowa Hakko Kirin. Y. K. has received consulting fees, speaking fees, honoraria and/or research grants from Astellas, Chugai, Japan Blood Products Organization, Mitsubishi-Tanabe, Pfizer, Ono and Bristol-Myers. M. J., Y. M. and S. I. declare no conflicts of interest. H. T. has received consulting fees and speaking fees from Japan Blood Products Organization. A. O. has no conflict of interest to declare. T. S. has received consulting fees, speaking fees, honoraria and/or research grants from Astellas, Chugai, Novartis, Japan Blood Products Organization, Shionogi, Mitsubishi-Tanabe, Pfizer, Ono and Bristol-Myers.