Johnson K – This is the first time that health-related quality of life (HRQOL) has been examined in juvenile idiopathic arthritis (JIA), demonstrating that effective therapies such as MTX can reverse the impairments of HRQOL and substantially improve a patient's life. Methods
Study to determine the efficacy and safety of second-line agents and their effect on HRQOL of pts with JIA
521 children (mean age, 8 yrs) were selected from a larger randomized trial aimed at evaluating the safety and efficacy of various doses of MTX
All subjects had polyarticular-course JIA and were newly treated with a standard dosage of MTX (10 mg/m2/wk) for 6 mos
After this period, nonresponders were randomized to receive either intermediate (15 mg/m2/wk) or high dosages (30 mg/m2/wk) for a further 6 mos
No other drug was allowed for the duration of the trial, except low-dose steroids and one NSAID
3,315 healthy children were used as controls
Results
After 6 mos of treatment with standard-dose MTX, 77% of pts had significant symptom improvement
A further 39 and 36 pts, respectively, were eligible for randomization to 6 subsequent mos of intermediate- or high-dose treatment
Significant improvement in HRQOL was noted after 6 mos in all CHQ health concept scores for the initial responders
This improvement in HRQOL was also seen after the nonresponders were treated with higher MTX doses
A major functional impairment remained in these pts despite the observed improvement in disease activity measures
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