[Methotrexate in the therapy of juvenile idiopathic arthritis].
Treatment with low-dose methotrexate (MTX) is an important element in the therapy of juvenile idiopathic arthritis (JIA). It could be demonstrated in placebo-controlled trials that MTX is a safe and effective drug which is generally well tolerated by children and adolescents. MTX is usually used at a dose of 10-15 mg/m(2)/week, whereby oral administration is preferred for children. Side effects occur mainly in the form of gastro-intestinal discomfort such as nausea and vomiting or raised transaminases, which can be effectively treated with folic-acid supplementation.There are no general recommendations to date regarding in particular duration and discontinuation of MTX treatment or combination treatment with other disease-modifying antirheumatic drugs or biologics. These unresolved questions are the subject of current trials in which biomarkers have an increasingly important role.
Holzinger
D
D
Institut für Immunologie, Universitätsklinikum Münster, Röntgenstr 21, 48149 Münster. dirk.holzinger@ukmuenster.de
Frosch
M
M
Föll
D
D
D000293:Adolescent; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D002648:Child; D018849:Controlled Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D008727:Methotrexate / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D005492:Folic Acid; D008727:Methotrexate