[Personal experience with methotrexate in the treatment of idiopathic juvenile arthritis]

Methotrexate was introduced in the treatment of juvenile idiopathic arthritis (JIA) about fifteen years ago. Today, methotrexate is the drug of choice in the basic treatment of JIA, especially for oligoarticular subtype The aim of this study is to show our experiences with this agent. In the period from 1996 to 2001 in the Pediatric Clinic--University of Zagreb 256 children with JIA were hospitalised--85 with polyarticular (33.2%) and 171 with oligoarticular subtype (66.8%). 34 of these patients (13.28%)--21 female and 13 male--16 with polyarticular and 18 with oligoarticular subtype were treated with methotrexate. The age at the beginning of the therapy was from 3 to 18 years (mean age 11.31 ys). The countinuos treatment with methotrexate lasted from 1 to 3 years. The dosage of methotrexate was 10-20 mg/m2, i.e. 0.3-0.5 mg/kg of body weight weekly. During patients' hospitalization the drug was administered parenterally, while at home it was continued to be given perorally. All of the patients took with methotrexate also nonsteroidal antiinflammatory drugs, and some corticosteroid therapy. All of the patients were submitted to regular physical therapy. The results of the treatment response were judged according to the global patients assessment (number of inflammated joints, degree of inflammation and functional disability), laboratory data (inflammation reactants, hemoglobin, RF). Statistically significant improvement of clinical and laboratory parameters (p < 0.01) was proved in 33 patients, while the improvement in one patient was minimal. Adverse reactions were rare and transitory.