Internal Med Medical News about juvenile idiopathic arthritis;response to methotrexate

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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.

Methods

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

Results

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