Article Text

PDF
The magnitude of early response to methotrexate therapy predicts long-term outcome of patients with juvenile idiopathic arthritis
  1. M Bartoli1,
  2. M Tarò2,
  3. S Magni-Manzoni1,
  4. A Pistorio2,
  5. F Traverso2,
  6. S Viola2,
  7. A Magnani2,
  8. C Gasparini1,
  9. A Martini2,
  10. A Ravelli2
  1. 1
    Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, Pavia, Italy
  2. 2
    Istituto di Ricovero e Cura a Carattere Scientifico G. Gaslini, Genova, Italy
  1. A Ravelli, Pediatria II, Istituto G. Gaslini, Largo G. Gaslini 5, 16147 Genova, Italy; angeloravelli{at}ospedale-gaslini.ge.it

Abstract

Objective: To investigate the relationship between the magnitude of clinical response in the first 6 months of methotrexate (MTX) therapy and long-term outcome in children with juvenile idiopathic arthritis (JIA).

Methods: The clinical charts of 125 JIA patients who were started with MTX and then followed for at least 5 years were reviewed. Based on the level of American College of Rheumatology (ACR) Pediatric response at 6 months, patients were divided in four mutually exclusive groups: (1) non-responders, (2) responders at 30%, (3) responders at 50%, and (4) responders at 70%. The long-term outcome in each response group was evaluated by calculating the percentage change in active and restricted joint counts from baseline to 1, 2 and 5 years and the frequency of inactive disease at 5 years.

Results: At 6 months, 42 patients were classified as non-responders, 24 as 30% responders, 26 as 50% responders, and 33 as 70% responders. Patients who had achieved a 70% response showed a significantly greater percentage improvement in active joint count between baseline to 5 years compared with non-responders and 30% responders, and a significantly greater percentage improvement in restricted joint count between baseline to 5 years compared with 30% responders. The 70% responders also had a greater frequency of inactive disease at 5 years compared with 30% responders,

Conclusions: Our results show that the achievement of an ACR Pediatric 70 response at 6 months after start of MTX therapy predicts a more favorable long-term outcome of patients with JIA.

Statistics from Altmetric.com

Footnotes

  • Competing interests: None declared.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.