Juvenile dermatomyositis
3. Gamma globulins
It is the third most widely used drug in the treatment of JDM. It is mainly used for the management of skin disease that is resistant to first-line treatment (corticosteroids and MTX) and/or initial treatment in case of severe disease.
It is administered intravenously, at a dose of 2 g/kg with a maximum dose of 70 g, every 4 weeks. The first two administrations can be given fortnightly if the patient requires it.
In recent years, subcutaneous administration of gamma globulin has been described in some patients with JDM, the main indication for which is persistent skin activity and intolerance to intravenous administration. Since there is currently little experience with this route of administration, it is recommended only in cases where intravenous administration is not possible.
The most frequent side effects are infusion reaction or headache in the hours following administration, which are resolved by reducing the infusion rate and/or using paracetamol and/or antihistamines prior to administration.
