OBJECTIVE: To investigate the relationship between the magnitude of clinical response in the first 6 months of methotrexate (MTX) therapy and long-term outcome in children with juvenile idiopathic arthritis (JIA). METHODS: The clinical charts of 125 JIA patients who were started with MTX and then followed for at least 5 years were reviewed. Based on the level of American College of Rheumatology (ACR) Pediatric response at 6 months, patients were divided in four mutually exclusive groups: (1) non-responders, (2) responders at 30%, (3) responders at 50%, and (4) responders at 70%. The long-term outcome in each response group was evaluated by calculating the percentage change in active and restricted joint counts from baseline to 1, 2 and 5 years and the frequency of inactive disease at 5 years. RESULTS: At 6 months, 42 patients were classified as non-responders, 24 as 30% responders, 26 as 50% responders, and 33 as 70% responders. Patients who had achieved a 70% response showed a significantly greater percentage improvement in active joint count between baseline to 5 years compared with non-responders and 30% responders, and a significantly greater percentage improvement in restricted joint count between baseline to 5 years compared with 30% responders. The 70% responders also had a greater frequency of inactive disease at 5 years compared with 30% responders, CONCLUSIONS: Our results show that the achievement of an ACR Pediatric 70 response at 6 months after start of MTX therapy predicts a more favorable long-term outcome of patients with JIA.
OBJECTIVE: To investigate the relationship between the magnitude of clinical response in the first 6 months of methotrexate (MTX) therapy and long-term outcome in children with juvenile idiopathic arthritis (JIA). METHODS: The clinical charts of 125 JIA patients who were started with MTX and then followed for at least 5 years were reviewed. Based on the level of American College of Rheumatology (ACR) Pediatric response at 6 months, patients were divided in four mutually exclusive groups: (1) non-responders, (2) responders at 30%, (3) responders at 50%, and (4) responders at 70%. The long-term outcome in each response group was evaluated by calculating the percentage change in active and restricted joint counts from baseline to 1, 2 and 5 years and the frequency of inactive disease at 5 years. RESULTS: At 6 months, 42 patients were classified as non-responders, 24 as 30% responders, 26 as 50% responders, and 33 as 70% responders. Patients who had achieved a 70% response showed a significantly greater percentage improvement in active joint count between baseline to 5 years compared with non-responders and 30% responders, and a significantly greater percentage improvement in restricted joint count between baseline to 5 years compared with 30% responders. The 70% responders also had a greater frequency of inactive disease at 5 years compared with 30% responders, CONCLUSIONS: Our results show that the achievement of an ACR Pediatric 70 response at 6 months after start of MTX therapy predicts a more favorable long-term outcome of patients with JIA.
Authors: Halima Moncrieffe; Anne Hinks; Simona Ursu; Laura Kassoumeri; Angela Etheridge; Mike Hubank; Paul Martin; Tracey Weiler; David N Glass; Susan D Thompson; Wendy Thomson; Lucy R Wedderburn Journal: Pharmacogenet Genomics Date: 2010-11 Impact factor: 2.089
Authors: Amanda Brown; Raphael Hirsch; Tal Laor; Michael J Hannon; Marc C Levesque; Terence Starz; Kimberly Francis; C Kent Kwoh Journal: Arthritis Care Res (Hoboken) Date: 2012-12 Impact factor: 4.794
Authors: Anne Hinks; Halima Moncrieffe; Paul Martin; Simona Ursu; Sham Lal; Laura Kassoumeri; Tracey Weiler; David N Glass; Susan D Thompson; Lucy R Wedderburn; Wendy Thomson Journal: Ann Rheum Dis Date: 2011-04-22 Impact factor: 19.103
Authors: J Fráňová; Š Fingerhutová; K Kobrová; R Srp; D Němcová; J Hoza; M Uher; M Saifridová; L Linková; P Doležalová Journal: Pediatr Rheumatol Online J Date: 2016-06-14 Impact factor: 3.054