Long-Term Methotrexate Won't Help Kids With Juvenile Arthritis
TUESDAY, April 6 -- Longer treatment with the drug methotrexate doesn't reduce relapse rates in patients with juvenile idiopathic arthritis (JIA) that has gone into remission, a new study finds.
The research included 364 JIA patients, median age 11 years, in 29 countries. They were randomly assigned to continue taking methotrexate for either six (group 1) or 12 months (group 2) after the beginning of disease remission, which meant that the children were temporarily free of persistent joint pain, swelling and stiffness.
The median relapse-free time was 21 months in group 1 and 23 months in group 2. Of the 297 patients who stopped taking methotrexate while in remission, about 40 percent in both groups 1 and 2 had a JIA flare within a year.
"These data indicate a need for the stratification of patients with chronic inflammatory diseases to ensure that the intensity of treatment is adjusted to the patients' individual needs," wrote Dr. Dirk Foell, of the University of Muenster in Germany, and colleagues.
The use of methotrexate therapy in all JIA patients for longer than six months after remission cannot be recommended, they added.
The study appears in the April 7 issue of the Journal of the American Medical Association.
The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about juvenile arthritis.
Posted: April 2010