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Correspondence
Duration of methotrexate treatment until partial and total remission of refractory juvenile rheumatoid arthritis
  1. RIVA BRIK
  1. DRORA BERKOWITZ,
  2. MOSHE BERANT
  1. Section of Paediatric Rheumatology, Rambam Medical Centre and Technion Faculty of Medicine, Haifa 31096, Israel
  2. Department of Paediatrics, Rambam Medical Centre and, Technion Faculty of Medicine, Haifa, Israel
  1. Dr R Brik.

https://doi.org/10.1136/ard.57.3.174

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    Methotrexate (MTX) was an effective treatment of resistant juvenile rheumatoid arthritis (JRA) in a double blind, placebo controlled study.1 Its advantages over other second line agents,2 include oral administration, once a week dose, fewer side effects than parenteral gold,3 no known oncogenicity4 or long term effects on fertility.5 Therefore, paediatric rheumatologists tend to consider the use of MTX as a first choice for children with refractory JRA.6 ,7

    We considered the duration of MTX therapy required for the achievement of partial and total clinical remission of JRA, and conducted a prospective open trial of all patients with JRA who were given MTX treatment at the Paediatric Rheumatology Clinic of the Rambam Medical Centre, between January 1994 and January 1997.

    The patients had active JRA according to American College of Rheumatology (ACR) criteria8 and had failed to respond to adequate courses of non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids or disease modifying drugs (DMARDs). All the patients who …

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