title: Low-dose methotrexate in systemic onset juvenile chronic arthritis.
abstract: 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.
authors.affiliation: Section of Molecular Rheumatology, Clinical Research Centre and Northwick Park Hospital, Harrow, Middlesex, UK.
authors.forename: M
authors.initials: M
authors.lastname: Speckmaier
authors.forename: J
authors.initials: J
authors.lastname: Findeisen
authors.forename: P
authors.initials: P
authors.lastname: Woo
authors.forename: A
authors.initials: A
authors.lastname: Hall
authors.forename: J A
authors.initials: JA
authors.lastname: Sills
authors.forename: T
authors.initials: T
authors.lastname: Price
authors.forename: P
authors.initials: P
authors.lastname: Hollingworth
authors.forename: A
authors.initials: A
authors.lastname: Craft
authors.forename: B M
authors.initials: BM
authors.lastname: Ansell
mesh_terms: 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
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D008727:Methotrexate