Arthritis

07 April 2010

Long-Term Methotrexate Won't Help Kids With Juvenile Arthritis

Using drug for up to a year did not affect relapse rate, study found

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TUESDAY, April 6 (HealthDay News) -- 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.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about juvenile arthritis.

 

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Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.
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