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J Rheumatol. 1995 Aug;22(8):1574-6.

Frequency of relapse after discontinuation of methotrexate therapy for clinical remission in juvenile rheumatoid arthritis.

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  • 1Clinica Pediatrica dell'Universit√†, Istituto di Ricovero e Cura a Carattere Scientifico S. Matteo, Pavia, Italy.

Abstract

OBJECTIVE:

To investigate the outcome of children with juvenile rheumatoid arthritis (JRA) who discontinued taking methotrexate (MTX) therapy after the achievement of clinical remission.

METHODS:

We conducted a retrospective review of the clinical course of all consecutive patients with JRA treated with MTX at our department.

RESULTS:

Seventeen of the 30 patients who responded to treatment entered clinical remission 6 to 30 mo after beginning MTX therapy. All patients were discontinued from MTX within 2 to 5 mo. Five patients relapsed within 9 mo, whereas 12 patients had sustained remission for 12 mo or longer. Four of 5 children with extended pauciarticular JRA relapsed early after MTX discontinuation. These patients were less responsive to a further cycle of MTX, and 3 showed progression of radiographic joint lesions.

CONCLUSION:

These findings suggest that MTX should be continued in patients with extended pauciarticular JRA even after the achievement of clinical remission.

PMID:
7473486
[PubMed - indexed for MEDLINE]
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