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A retrospective study: Impact of consensus treatment plans on systemic therapy of pediatric morphea
Author(s) -
Do Ngan,
Ringold Sarah,
Sullivan Erin,
BrandlingBennett Heather
Publication year - 2020
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.14074
Subject(s) - medicine , morphea , regimen , retrospective cohort study , dermatology , systemic therapy , rheumatology , medical record , pediatrics , physical therapy , lichen sclerosus , cancer , breast cancer
Background Morphea is an inflammatory and fibrosing condition that affects the skin and subcutaneous structures. Morphea is managed by dermatologists, rheumatologists, or both. Prior studies have suggested there is significant variability in approach to treatment. In 2012, the Childhood Arthritis and Rheumatology Research Alliance (CARRA) published consensus treatment plans (CTPs) for pediatric morphea to develop more standardized treatment plans for patients requiring systemic therapy. We aimed to assess whether the publication of CTPs has impacted care of patients with morphea at our institution. Methods Data were collected via a retrospective review of medical records of 61 pediatric patients diagnosed with morphea at Seattle Children's Hospital (SCH) from January 1, 2005, to December 12,2017. Results Prior to the publication of CTPs, 2 out of 24 patients (8.3%) were treated with a regimen that matched a subsequent CTP. After publication of CTPs, 29 out of 37 patients (78.4%) were treated with a regimen that matched a CTP ( P < 0.001). A subanalysis was performed to assess the number of patients who needed second‐ or third‐line therapies. Of those who followed a CTP therapy plan (n = 26), 3 patients (11.5%) needed a second‐line therapy compared with 11 patients (44%) in the no‐CTP followed group (n = 25), ( P = 0.012). Conclusions The publication of CTPs led to a significant change in treatment approach for patients with morphea requiring systemic therapy at SCH. Patients treated with one of the treatment plans recommended by the CTPs were less likely to need second‐line systemic therapy.