ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1156

Effectivity of Methotrexate in Therapy of Juvenile Idiopathic Enthesitis-Related Arthritis

Katharina Geitz1 and Ivan Foeldvari2, 1Pediatric Rheumatology, Hamburger Zentrum Kinder-und Jugendrheumatologie, Hamburg, Germany, 2Kinder- und Jugenrheumatologie, Hamburger Zentrum Kinder-und Jugendrheumatologie, Hamburg, Germany

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Title: Pediatric Rheumatology - Clinical and Therapeutic Aspects: Juvenile Idiopathic Arthritis

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Juvenile idiopathic enthesitis related arthritis (enthJIA) represents 5 to 10% of children with JIA. Most patients present with peripheral arthritis and enthesitis. Methotrexate was not formally studied regarding effectivity for the peripheral joint involvement of this subset. Aim of our study was to assess the effectivity of methotrexate in peripheral joint involvement of enthesitis related JIA.

Methods:

We conducted a chart review of patients with juvenile idiopathic enthesitis related arthritis, who have been treated at least for 3 months with MTX since 2005. The clinical and demographic parameters of the patients were assessed. 

Results:

We identified 73 patients with confirmed diagnosis of enthJIA, who were treated at least for 3 months with MTX. At the initiation of the therapy the average active joint count was 2,5 and the number of active enthesitis sites were 0,9. The mean CHAQ value was 0,55 and the mean pain score was 1,20 and the mean well being score was 1,26. The mean physician global was 1,74.  At 3,6 and 9 months the active joint count was reduced by 18%, 44% and 53% , the number of painful joints by 22%, 36% and 47% and the number of swollen joints by  70%, 70% and 65%. The number of  active enthesitis sites were reduced by 3,6 and 9 months by 44.5%, 61% and  50%. The CRP was reduced at 3,6 and 9 months by 49%, 70% and by 76%.The CHAQ score decreased at 3,6 and 9 months by 45%, 63% and 62% ,  the pain-score by 38%, 62%  and 51% and the well-being score by 52%, 66% and 49% and the physician global by 58%, 65% and 65%.   

Conclusion:

In this retrospective chart review we could demonstrate the effectivity of MTX for peripheral joint involvement and for enthesitis. Interestingly only after 6 months of MTX therapy was  the highest rate of improvement reached. Prospective controlled trial would be important to prove our results.

Disclosure:

K. Geitz,
None;

I. Foeldvari,
None.

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