Recommendations for the use of methotrexate in patients with juvenile idiopathic arthritis

Calvo, Inmaculada; Antón, Jordi; Robledillo, Juan Carlos López; Inocencio, Jaime de; Gámir, M.L. Gámir; Merino, Rosa; Lacruz, Luis; Camacho, M.; Rua, M.J.; Bustabad, Sagrario; Cordovés-Rego, G. Díaz

doi:10.1016/j.anpede.2015.05.022

Cited by 7 publications

(8 citation statements)

References 26 publications

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“…The distribution by JIA subtype is: 33% polyarticular with RF (-), 26% oligoarticular (21% pure oligoarticular and 5% exten-ded oligoarticular), 17% polyarticular RF (+), 12% systemic, 7% psoriatic and 5% associated with enthesitis ( figure 1C). Regarding treatment (GES incorporates and guarantees access to biological medicines since 2013), 48% of the patients are taking biological medicines ( figure 1D), due to intolerance or lack of response to methotrexate, used as first-line treatment in all patients, suspended or associated with biological medicines; etanercep, adalimumab, infliximab, abatacept and tocilizumab, sequentially, according to the established response criteria 5,[8][9][10][11][12] . Figure 2 figure 2B) demonstrating the distance and travel time required to reach the HPM, which could add up to 1,000 km to the centers of reference.…”

Section: Resultsmentioning

confidence: 99%

Aporte del uso de herramientas básicas de Telemedicina en la atención de niños y adolescentes con Artritis idiopática juvenil, en el Hospital de Puerto Montt. Chile

Strickler¹,

Palma²,

Charris³

et al. 2018

Rev. chil. pediatr.

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Children and adolescents with rheumatologic diseases require specialized and comprehensive care, but pediatric rheumatologists and immunologists are concentrated in hospitals with specific, highcost and modern technology. Considering that some patients with juvenile idiopathic arthritis (JIA) live in rural, remote and limited accessibility areas, the use of Telemedicine (TM) can optimize diagnosis, follow-up and prognosis. Objective: Reporting 10 years of experience of a mixed care model: face-to-face and distance, using basic TM; the institutional impact, advantages, disadvantages and acceptance informed by parents and patients. Patients and Method: Exploratory, descriptive, and retrospective study with qualitative component. After the authorization of a scientific-ethics committee of the Reloncaví Health Service and the application of informed consent, a review of medical records was carried out and a qualitative survey was applied to parents and children over 14 years of age with JIA, seen between 2005-2015 in the pediatric ambulatory rheumatology polyclinic of Puerto Montt Hospital. Results: The were 27/35 participating patients with JIA attended by a trained pediatrician and assisted by distance (1,000 km) by an immunologist. The 8/35 patients did not answer by choice or change of address. The 70% of parents and patients accepted the model of care and 4% would prefer sporadic care only by specialists for diagnosis and follow-up. The number of patients transferred annually decreased from 10 to 1. The advantages of the care model outweighed the disadvantages perceived by parents and JIA patients. Conclusion: The use of TM tools in JIA decreased transfers, improved follow-up and were considered advantageous by patients and their parents. 60ORIGINAL ARTICLE Telemedicine -AS. Strickler et al

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Section: Resultsmentioning

confidence: 99%

Aporte del uso de herramientas básicas de Telemedicina en la atención de niños y adolescentes con Artritis idiopática juvenil, en el Hospital de Puerto Montt. Chile

Strickler¹,

Palma²,

Charris³

et al. 2018

Rev. chil. pediatr.

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“…Назначение ГИБП в связи с недостаточной эффективностью МТ потребовалось 83 (33,6%) больным. С О В P E М Е Н Н А Я Р Е В М А Т О Л О Г И Я № 3 ' 1 9 О Р И Г И Н А Л Ь Н Ы Е И С С Л Е Д О В А Н И Я Полученные нами результаты сопоставимы с данными многочисленных исследований, посвященных изучению эффективности и безопасности терапии МТ у пациентов с ЮИА [5][6][7][8][9][12][13][14][15][16]. N. Ruperto и соавт.…”

Section: д е м о г р а ф и ч е с к а я и к л и н и ч е с к а я х а р unclassified

“…Основой патогенетического лечения ЮИА является назначение иммуносупрессивных препаратов [2][3][4][5]. Особое место среди них занимает метотрексат (МТ), который в настоящее время признан «золотым стандартом» лечения ревматоидного артрита взрослых и ЮИА [5,6].…”

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“…МТ -наиболее широко применяемый базисный противовоспалительный препарат для лечения ЮИА, который используется с этой целью уже более 25 лет. По данным различных исследований, его эффективность при ЮИА составляет от 30 до 60-70% [5][6][7][8][9][10]. Хотя проводились исследования предикторов эффективности терапии МТ, четкие показания для его назначения не сформулированы.…”

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Can remission be in juvenile idiopathic arthritis without the use of biological agents?

Валиева

Glazyrina

Кулешов

et al. 2019

Sovremennaâ revmatologiâ

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Цель исследования-оценить эффективность и безопасность терапии метотрексатом (МТ) для подкожного (п/к) введения у пациентов с ювенильным идиопатическим артритом (ЮИА) без системных проявлений. Пациенты и методы. Представлены результаты проспективного исследования эффективности и безопасности МТ у 247 пациентов в возрасте от 1 года до 17 лет с суставными вариантами ЮИА, а также частота показаний для назначения генно-инженерных биологических препаратов данной категории больных. У всех пациентов ЮИА протекал без системных проявлений: у 106 был олигоартикулярный суставной синдром, у 94-полиартикулярный негативный по ревматоидному фактору (РФ), у 15-полиартикулярный позитивный по РФ, у 20-энтезитный, у 12-псориатический артрит. Диагноз ЮИА устанавливали на основании критериев ILAR. Всем пациентам после верификации диагноза назначался МТ в виде п/к инъекций в дозе 15 мг/м 2 /нед. Результаты и обсуждение. После 3 мес терапии МТ 50 и 70% улучшение по критериям ACRпеди было зарегистрировано у 65 и 53% пациентов соответственно. После 6, 9 и 12 мес терапии стадия неактивной болезни или ремиссия отмечалась у 44,5; 85 и 100% пациентов соответственно. Выводы. Парентеральное введение МТ способствует достижению ремиссии заболевания и восстановлению функции суставов у пациентов с ЮИА без внесуставных проявлений. Наряду с высокой терапевтической эффективностью МТ обладал хорошей переносимостью и благоприятным профилем безопасности.

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“…To date, despite the wide use of MTX, there is a lack of consensus-based clinical and therapeutic recommendations for the use of MTX in the management of patients with JIA. Only two papers, one recently-published article from the Spanish Society of Paediatric Rheumatology (Sociedad Española de Reumatología Pediátrica; SERPE) [ 3 ], and an older article by the Pediatric Immunology and Rheumatology Division of the Centre for Child Health, Heinrich-Heine-University, Düsseldorf, Germany [ 4 ] currently deal with this task.…”

Section: Introductionmentioning

confidence: 99%

Methotrexate in juvenile idiopathic arthritis: advice and recommendations from the MARAJIA expert consensus meeting

et al. 2018

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BackgroundConventional pharmacological therapies for the treatment of juvenile idiopathic arthritis (JIA) consist of non-biological, disease-modifying antirheumatic drugs, among which methotrexate (MTX) is the most commonly prescribed. However, there is a lack of consensus-based clinical and therapeutic recommendations for the use of MTX in the management of patients with JIA. Therefore, the Methotrexate Advice and RecommendAtions on Juvenile Idiopathic Arthritis (MARAJIA) Expert Meeting was convened to develop evidence-based recommendations for the use of MTX in the treatment of JIA.MethodsThe preliminary executive committee identified a total of 9 key clinical issues according to the population, intervention, comparator, outcome (PICO) approach, and performed an evidence-based, systematic, literature review. During the subsequent Expert Meeting, the relevant evidence was assessed and graded, and 10 recommendations were made.ResultsRecommendations relating to the efficacy, optimal dosing and route of administration and duration of treatment with MTX in JIA, and to the issue of folic acid supplementation to prevent MTX side effects, use of MTX in the treatment of chronic JIA-associated uveitis, combination treatment with biologic agents, and the use of vaccinations in patients with JIA were developed. The selected topics were considered to represent clinically important issues facing clinicians caring for patients with JIA. Evidence was insufficient to formulate recommendations for the use of biomarkers predictive of treatment response.ConclusionsThese consensus recommendations provide balanced and evidence-based recommendations designed to have broad value for physicians and healthcare clinicians involved in the clinical management of patients with JIA.

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Recommendations for the use of methotrexate in patients with juvenile idiopathic arthritis

Cited by 7 publications

References 26 publications

Aporte del uso de herramientas básicas de Telemedicina en la atención de niños y adolescentes con Artritis idiopática juvenil, en el Hospital de Puerto Montt. Chile

Aporte del uso de herramientas básicas de Telemedicina en la atención de niños y adolescentes con Artritis idiopática juvenil, en el Hospital de Puerto Montt. Chile

Can remission be in juvenile idiopathic arthritis without the use of biological agents?

Methotrexate in juvenile idiopathic arthritis: advice and recommendations from the MARAJIA expert consensus meeting

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