The magnitude of early response to methotrexate therapy predicts long-term outcome of patients with juvenile idiopathic arthritis.

@article{citeulike:2428677, abstract = {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.}, address = {Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, Pavia, Italy.}, author = {Bartoli, M. and Tar\`{o}, M. and Magni-Manzoni, S. and Pistorio, A. and Traverso, F. and Viola, S. and Magnani, A. and Gasparini, C. and Martini, A. and Ravelli, A. }, citeulike-article-id = {2428677}, doi = {10.1136/ard.2007.073445}, issn = {1468-2060}, journal = {Ann Rheum Dis}, keywords = {jia, mtx}, month = {March}, number = {3}, pages = {370--374}, posted-at = {2008-02-26 07:55:54}, priority = {5}, title = {The magnitude of early response to methotrexate therapy predicts long-term outcome of patients with juvenile idiopathic arthritis.}, url = {http://dx.doi.org/10.1136/ard.2007.073445}, volume = {67}, year = {2008} }

TY - JOUR ID - citeulike:2428677 L3 - citeulike-article-id:2428677 TI - The magnitude of early response to methotrexate therapy predicts long-term outcome of patients with juvenile idiopathic arthritis. JF - Ann Rheum Dis VL - 67 IS - 3 SP - 370 EP - 374 AD - Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, Pavia, Italy. SN - 1468-2060 N2 - 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. KW - jia KW - mtx AU - Bartoli, M AU - Tarò, M AU - Magni-Manzoni, S AU - Pistorio, A AU - Traverso, F AU - Viola, S AU - Magnani, A AU - Gasparini, C AU - Martini, A AU - Ravelli, A PY - 2008/03// UR - http://dx.doi.org/10.1136/ard.2007.073445 ER -