Low-dose methotrexate in systemic onset juvenile chronic arthritis.
Twelve children with severe systemic juvenile chronic arthritis, all requiring high dose corticosteroids, have been admitted to a pilot study to evaluate the effect of low-dose methotrexate (mean dose: 8.5 mg/M2) on disease activity over a 6 month period. Definite improvement occurred in 4 children, allowing reduction of the steroid dose in 2 cases. Two children showed an acute flare of disease activity during the treatment period and in three, steroids had to be increased. Overall, side effects were rare with a rise in transaminases only occurring once. MTX blood levels taken on 14 occasions in 8 children documented absorption in all cases with a mean level of 3.45 x 10(-7) mol/l on a mean dose of 9 mg/M2. Low-dose MTX appears to be a safe drug in the short term treatment of severe systemic JCA with beneficial effect in about a third of patients. Long-term controlled trials will be needed to evaluate its role in the treatment of systemic disease as well as side effects.
Speckmaier
M
M
Section of Molecular Rheumatology, Clinical Research Centre and Northwick Park Hospital, Harrow, Middlesex, UK.
Findeisen
J
J
Woo
P
P
Hall
A
A
Sills
J A
JA
Price
T
T
Hollingworth
P
P
Craft
A
A
Ansell
B M
BM
D000042:Absorption; D000284:Administration, Oral; D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D001171:Arthritis, Juvenile / Q000097:blood / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D008727:Methotrexate