title: Methotrexate in juvenile idiopathic arthritis: towards tailor-made treatment.
abstract: Methotrexate (MTX) is the key treatment in juvenile idiopathic arthritis (JIA). Nevertheless, MTX is not always sufficiently efficacious and can lead to adverse effects, which compromises complete disease control. In such cases, combination therapies with biologicals are given, even at MTX start, before knowing the patients' MTX response. Ideally, clinicians should be able to practice precision medicine by knowing before or early after MTX start, which patients will benefit from MTX only and which patients will not, thus requiring addition of biologicals. To make such tailor-made treatment decisions, clinicians require tools to optimize MTX treatment. In this review, we focus on tools for tailor-made MTX treatment in JIA.
authors.affiliation: Department of Pediatric Rheumatology and Immunology, University Medical Centre Utrecht, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: Maja Bulatović
authors.initials: MB
authors.lastname: Ćalasan
authors.forename: Nico M
authors.initials: NM
authors.lastname: Wulffraat
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000235:genetics / Q000628:therapy*; D001688:Biological Products / Q000627:therapeutic use; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D008727:Methotrexate
keywords: Pavlovian conditioning; intolerance; juvenile idiopathic arthritis; methotrexate; polyglutamates; prediction; response; single nucleotide polymorphisms