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Time to treatment as an important factor for the response to methotrexate in juvenile idiopathic arthritis
Arthritis Care and Research , 01/05/09

Albers HM et al. – In children with juvenile idiopathic arthritis (JIA), an earlier start of methotrexate (MTX) treatment leads to an increased response.

• Aim was to identify of clinical and genetic factors that influence the response to MTX in JIA pts (n=128)
• 11 clinical parameters and genotypes of 6 SNPs in 5 genes related to the mechanism of action of MTX compared between MTX responders and nonresponders

• Time from diagnosis to start of MTX treatment, physician's global assessment at baseline, and the starting dose were associated with the response to MTX at 6 mo after initiation
• Pts with a shorter time from diagnosis to start of MTX and a higher disease activity with a lower MTX dose showed an increased response
• Effect of starting dose on MTX response was mainly due to the influence of systemic JIA subtype
• The time from diagnosis to start of MTX treatment and physician's global assessment at baseline were highly correlated
• Therefore, the precise effect size of each independent variable could not be determined

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