[Treatment with low-dose methotrexate in intractable juvenile chronic arthritis].
14 patients suffering from Juvenile Chronic Arthritis unresponsive to NSAIDS were enrolled in this open study. There were two patients with a systemic form, nine patients with polyarticular form. All patients received methotrexate administered orally in one or two divided doses; the dose was 0.3-0.5 mg/kg/week. Clinical improvement occurred in most of the cases; remission was achieved in 5 out of 9 polyarticular form, in one out of the two systemic form and in two out of the three pauciarticular form. All patients showed a significant improvement in the clinical parameters except one with a pauciarticular form (duration of morning stiffness, number of swollen joints and number of painful joints). The effects on laboratory indexes were a decrease in ESR and CRP in about 50% of the cases, an increase up to the normal value of hemoglobin in about 30% of the cases. Two patients experienced a transient gastrointestinal discomfort and 3 had a mild elevation of serum aminotransferase levels which were restored after a reduction of the drug. In conclusion our data confirm that methotrexate at low dosage is more effective than other second-line agents and has fewer side effects. In our opinion methotrexate can today be considered the first choice for Juvenile Chronic Arthritis unresponsive to NSAIDS.
Lepore
L
L
Clinica Pediatrica, Istituto per l'Infanzia Burlo Garofolo, Trieste, Italia.
Pennesi
M
M
D000284:Administration, Oral; D000293:Adolescent; D001171:Arthritis, Juvenile / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D012074:Remission Induction; D013997:Time Factors
D008727:Methotrexate
Trattamento con metotrexate a basse dosi nell'artrite cronica giovanile intrattabile.