Background
Methotrexate (MTX) is the mostly used second line agent to treat Juvenile idiopathic arthritis (JIA). This study presents a retrospective data evaluation.
Objectives
To prove the efficacy and safety of MTX in all subtypes of JIA in a retrospective cohort.
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Methods
Single center open-label evaluation of the efficacy and safety of MTX treatment in patients with JIA where treatment was initiated between 31 st of March 2005 and 31 st of December 2007.
Results
105 patients were MTX initiated aged between 1 to 17 years. 61 of them were female (58.1%). The mean treatment duration was 13.9 months. The mean MTX dose was 14.7 mg/m2/week. The response to therapy is shown in table 1, response occurred at months 3 and stayed stable over the observation period.
Table 1
baseline | At 3 months | At 6 months | At 12 months | |
|---|---|---|---|---|
CHAQ-pain subscale | 0.886 | 0.466 | 0.386 | 0.338 |
CHAQ-disability subscale | 0.76 | 0.491 | 0.425 | 0.343 |
CHAQ-severity subsccale | 0.398 | 0.248 | 0.184 | 0.207 |
Number of swollen joints | 2.4 | 0.8 | 0.6 | 0.4 |
Number of tender joints | 2.6 | 1.4 | 1.1 | 0.8 |
Number of joints with LROM | 3.3 | 2.8 | 2.4 | 2.4 |
Physician global (VAS) | 2.4 | 1.0 | 0.8 | 0.6 |
Elevated CRP | 45.7% | 14.3% | 12.5% | 42.9% |
Elevated Sedimentation rate | 43.8% | 17.5% | 21.1% | 42.1% |
Adverse effects (AE) were reported by 41% of the patients, which were evenly distributed over the observation period. One severe AE occurred, one patient died with ALL.
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Discussion
In this real world retrospective study of all JIA subsets MTX appears to be a safe and effective drug.
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