Dermatomyositis
Meaning of dermatomyositis: For the purposes of this Statement of Principles, dermatomyositis: (a) means a chronic inflammatory disease characterised by inflammatory skin changes, usually accompanied by progressive and symmetric skeletal muscle weakness; and (b) includes amyopathic dermatomyositis.
Reasonable Hypothesis (RH) — Statement of Principles No. 70 of 2022
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting dermatomyositis or death from dermatomyositis with the circumstances of a person's relevant service:
- (1)taking a drug from the specified list of drugs for at least the 4 weeks before the clinical onset of dermatomyositis;
Note: specified list of drugs is defined in the Schedule 1 - Dictionary.
- (2)taking hydroxyurea for at least the 6 months before the clinical onset of dermatomyositis;
- (3)taking an immune checkpoint inhibitor or interferon alfa within the 1 year before the clinical onset of dermatomyositis;
Note: Examples of immune checkpoint inhibitors include ipilimumab, nivolumab, pembrolizumab and tremelimumab.
- (4)taking a drug which is associated in the individual with the clinical onset of dermatomyositis during drug therapy and either: (a) the improvement of dermatomyositis within 2 months of discontinuing or tapering drug therapy; or (b) the redevelopment of dermatomyositis on rechallenge with the same drug; and where taking the drug continued for at least the 7 days before the clinical onset of dermatomyositis;
- (5)having a malignant neoplasm, other than non-melanotic malignant neoplasm of the skin, within 5 years of the clinical onset of dermatomyositis;
- (6)taking a drug from the specified list of drugs for at least the 4 weeks before the clinical worsening of dermatomyositis;
Note: specified list of drugs is defined in the Schedule 1 - Dictionary.
- (7)taking hydroxyurea for at least the 6 months before the clinical worsening of dermatomyositis;
- (8)taking an immune checkpoint inhibitor or interferon alfa within the 1 year before the clinical worsening of dermatomyositis;
Note: Examples of immune checkpoint inhibitors include ipilimumab, nivolumab, pembrolizumab and tremelimumab.
- (9)taking a drug which is associated in the individual with: (a) the clinical worsening of dermatomyositis during drug therapy; and (b) the improvement of dermatomyositis within 2 months of discontinuing or tapering drug therapy; and where taking the drug continued for at least the 7 days before the clinical worsening of dermatomyositis;
- (10)having a malignant neoplasm, other than non-melanotic malignant neoplasm of the skin, within 5 years of the clinical worsening of dermatomyositis;
- (11)inability to obtain appropriate clinical management for dermatomyositis;
Aggravation-only factors: the factors in subsections 9(6) to 9(11) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
Balance of Probabilities (BoP) — Statement of Principles No. 71 of 2022
11 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, dermatomyositis or death from dermatomyositis is connected with the circumstances of a person's relevant service:
- (1)taking a drug from the specified list of drugs for at least the 4 weeks before the clinical onset of dermatomyositis;
Note: specified list of drugs is defined in the Schedule 1 - Dictionary.
- (2)taking hydroxyurea for at least the 6 months before the clinical onset of dermatomyositis;
- (3)taking an immune checkpoint inhibitor or interferon alfa within the 1 year before the clinical onset of dermatomyositis;
Note: Examples of immune checkpoint inhibitors include ipilimumab, nivolumab, pembrolizumab and tremelimumab.
- (4)taking a drug which is associated in the individual with the clinical onset of dermatomyositis during drug therapy and either: (a) the improvement of dermatomyositis within 2 months of discontinuing or tapering drug therapy; or (b) the redevelopment of dermatomyositis on rechallenge with the same drug; and where taking the drug continued for at least the 7 days before the clinical onset of dermatomyositis;
- (5)having a malignant neoplasm, other than non-melanotic malignant neoplasm of the skin, within 5 years of the clinical onset of dermatomyositis;
- (6)taking a drug from the specified list of drugs for at least the 4 weeks before the clinical worsening of dermatomyositis;
Note: specified list of drugs is defined in the Schedule 1 - Dictionary.
- (7)taking hydroxyurea for at least the 6 months before the clinical worsening of dermatomyositis;
- (8)taking an immune checkpoint inhibitor or interferon alfa within the 1 year before the clinical worsening of dermatomyositis;
Note: Examples of immune checkpoint inhibitors include ipilimumab, nivolumab, pembrolizumab and tremelimumab.
- (9)taking a drug which is associated in the individual with: (a) the clinical worsening of dermatomyositis during drug therapy; and (b) the improvement of dermatomyositis within 2 months of discontinuing or tapering drug therapy; and where taking the drug continued for at least the 7 days before the clinical worsening of dermatomyositis;
- (10)having a malignant neoplasm, other than non-melanotic malignant neoplasm of the skin, within 5 years of the clinical worsening of dermatomyositis;
- (11)inability to obtain appropriate clinical management for dermatomyositis;
Aggravation-only factors: the factors in subsections 9(6) to 9(11) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
