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of Rheumatology Copyright © 2010. All rights reserved. Table 1. Methotrexate treatment regimen for linear scleroderma clinical vignette. The number of respondents (Resp) who specified a given initial methotrexate (MTX) dose and route of administration for the clinical vignette of a 4-year-old girl with linear scleroderma of her leg are shown. Initial MTX dose refers to the dose specified at the start of treatment, and is in milligrams per kilogram body weight per weekly dose (mg/kg). Doses that had been specified as milligrams per square meter of body surface area (mg/m2) were converted to mg/kg, assuming that the vignette patient was at the 50% for height and weight for a 4.5-year-old girl; this gave her a body surface area of 0.7 m2. An MTX dose of 10 mg/m2 became 0.41 mg/kg, 15 mg/m2 became 0.62 mg/kg, 20 mg/m2 became 1 mg/kg. Duration is expressed in months. Initial MTX No. Resp No. SC No. Oral No. SC/Oral Median Induction Median Total No. Did Not Dose Ind: number of respondents who specified separate induction and maintenance phases; SC: number of respondents who specified treating with the subcutaneous form of MTX; Oral: number of respondents who specified treating with the oral form of MTX; SC/Oral: number of respondents who would treat with either the subcutaneous or oral form of MTX; Did not specify: number of respondents who did not specify a treatment duration. Downloaded on November 15, 2021 from www.jrheum.org vignette patient if the patient presented differently. Most (68.1%, 77/113) would treat less intensely (less or no corticosteroid, no treatment, no MTX, or shorter treatment duration) if the disease began 2 years before presentation to the pediatric rheumatologist, the lesion showed mild induration but no warmth or color change, and laboratory markers were Li, et al: Pediatric localized scleroderma 179 Personal non-commercial use only. The Journal of Rheumatology Copyright © 2010. All rights reserved. Table 2. Initial corticosteroid (CS) treatment regimens for linear scleroderma clinical vignette. The number of respondents (Resp) who specified a given CS dosing regimen for the clinical vignette of a 4-year-old girl with linear scleroderma of her leg are shown. Treatment durations are in months. The listed initial prednisone doses represent milligrams per kilogram (mg/kg) body weight per day. Intravenous methylprednisone (IV MP) was dosed at 30 mg/kg/dose, at infusion frequencies of 1 infusion per month (1/mo), 3 consecutive daily infusions per month (3 days/mo), 1 infusion per week (1/wk), or 3 daily infusions per week (3 days/wk). All 31 respondents who specified combination CS treatment (Comb) would initially treat the patient with IV MP; 24 would also initially treat with prednisone, and the remaining 7 would use prednisone for maintenance treatment. Initial CS Dose No. Resp No. Prednisone Overall no., duration, or range 114 34 45 31 2.0 0.25–6 QOD: every other day dosing; No. Prednisone Only: number of respondents who specified only using the oral form of corticosteroid for treatment; No. IV MP Only: number of respondents who specified only using the intravenous form of corticosteroid for treatment; No. Comb: number of respondents who specified treating with both the intravenous and oral forms of corticosteroid; NA: not applicable.
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