Document Detail


Predictors of poor response to methotrexate in polyarticular-course juvenile idiopathic arthritis: analysis of the PRINTO methotrexate trial.
MedLine Citation:
PMID:  20525842     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine whether baseline demographic, clinical, articular and laboratory variables predict methotrexate (MTX) poor response in polyarticular-course juvenile idiopathic arthritis. METHODS: Patients newly treated for 6 months with MTX enrolled in the Paediatric Rheumatology International Trials Organization (PRINTO) MTX trial. Bivariate and logistic regression analyses were used to identify baseline predictors of poor response according to the American College of Rheumatology pediatric (ACR-ped) 30 and 70 criteria. RESULTS: In all, 405/563 (71.9%) of patients were women; median age at onset and disease duration were 4.3 and 1.4 years, respectively, with anti-nuclear antibody (ANA) detected in 259/537 (48.2%) patients. With multivariate logistic regression analysis, the most important determinants of ACR-ped 70 non-responders were: disease duration > 1.3 years (OR 1.93), ANA negativity (OR 1.77), Childhood Health Assessment Questionnaire (CHAQ) disability index > 1.125 (OR 1.65) and the presence of right and left wrist activity (OR 1.55). Predictors of ACR-ped 30 non-responders were: ANA negativity (OR 1.92), CHAQ disability index > 1.14 (OR 2.18) and a parent's evaluation of child's overall well-being < or = 4.69 (OR 2.2). CONCLUSION: The subgroup of patients with longer disease duration, ANA negativity, higher disability and presence of wrist activity were significantly associated with a poorer response to a 6-month MTX course.
Authors:
Iris Vilca; Pablo Garcia Munitis; Angela Pistorio; Angelo Ravelli; Antonella Buoncompagni; Blanca Bica; Lucia Campos; Renate Häfner; Michael Hofer; Seza Ozen; Christian Huemer; Sang Cheol Bae; Flavio Sztajnbok; Olga Arguedas; Ivan Foeldvari; Hans Iko Huppertz; Maria Luz Gamir; Bo Magnusson; Frank Dressler; Yosef Uziel; Marion A J van Rossum; Peter Hollingworth; Gail Cawkwell; Alberto Martini; Nicolino Ruperto;
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-06-04
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  69     ISSN:  1468-2060     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-23     Completed Date:  2010-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  1479-83     Citation Subset:  IM    
Affiliation:
IRCCS G Gaslini, Pediatria II, Reumatologia, PRINTO, Genova, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antibodies, Antinuclear / analysis
Antirheumatic Agents / therapeutic use*
Arthritis, Juvenile Rheumatoid / drug therapy*,  immunology
Child
Child, Preschool
Disability Evaluation
Female
Follow-Up Studies
Humans
Immunosuppressive Agents / therapeutic use*
Male
Methotrexate / therapeutic use*
Prognosis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibodies, Antinuclear; 0/Antirheumatic Agents; 0/Immunosuppressive Agents; 59-05-2/Methotrexate
Investigator
Investigator/Affiliation:
Kevin J Murray / ; Rik Joos / ; Carine Wouters / ; Sheila Oliveira / ; Claudia Saad Magalhães / ; Virginia Ferriani / ; Dimitrina Mihaylova / ; Pavla Dolezalova / ; Pekka Lahdenne / ; Kirsten Minden / ; Riva Brik / ; Valeria Gerloni / ; Maria Alessio / ; Fabrizia Corona / ; Fernanda Falcini / ; Francesco Zulian / ; Maria Giannina Alpigiani / ; Elisabetta Cortis / ; Loredana Lepore / ; Roberta Galasso / ; Ruben Burgos-Vargas / ; Nico Wulffraat / ; Rebecca ten Cate / ; Renée van Soesberger / ; Line Asplin / ; Berit Flato / ; Marite Rygg / ; Richard Vesely / ; Julia Garcia-Consuegra / ; Rosa Merino / ; Immaculada Calvo / ; Boel Andersson-Gare / ; Rotraud Saurenmann / ; Marie-Joseph Sauvain / ; Aysin Bakkaloglu / ; Huri Ozdogan / ; Eileen Baildam / ; Joyce Davidson / ; Helen Foster / ; Jo Walsh / ; Ann Hall / ; Helen Venning / ; Pat Woo / ; Phil Hashkes / ; Yukiko Kimura /

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