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Title: Methotrexate improves the health-related quality of life of children with juvenile idiopathic arthritis
Authors: Céspedes-Cruz, Adriana ×
Gutiérrez-Suárez, Raúl
Pistorio, Angela
Ravelli, Angelo
Loy, Anna
Murray, Kevin J
Gerloni, Valeria
Wulffraat, Nico M
Oliveira, Sheila
Walsh, Jo
Calvo Penades, Immaculada
Alpigiani, Maria Giannina
Lahdenne, Pekka
Saad-Magalhães, Claudia
Cortis, Elisabetta
Lepore, Loredana
Kimura, Yukiko
Wouters, Carine
Martini, Alberto
Ruperto, Nicolino #
Issue Date: Mar-2008
Publisher: H.K. Lewis
Series Title: Annals of the rheumatic diseases vol:67 issue:3 pages:309-14
Abstract: OBJECTIVES: To examine the change in health-related quality of life (HRQOL) and its determinants in children with juvenile idiopathic arthritis (JIA) treated with methotrexate (MTX). METHODS: Patients were extracted from the PRINTO clinical trial aimed to evaluate the efficacy and safety profile of MTX administered in standard, intermediate or higher doses (10, 15 and 30 mg/m2/week respectively). Children with polyarticular-course JIA, who were less than 18 years and had a complete HRQOL assessment were included. RESULTS: A total of 521 children were included. At baseline, JIA patients showed poorer HRQOL (p<0.01) as compared to healthy children. In 207/412 (50%) and 63 (15%) children, HRQOL values were 2 standard deviation from the mean of healthy controls in the physical and psychosocial summary scale, respectively. After 6 months of therapy with standard-dose MTX, there was a statistical significant improvement in all HRQOL health concepts, particularly in the physical ones. Similar improvements were observed in the patients non-responders to standard dose MTX who were subsequently randomized to higher dose-MTX. The presence of marked disability at baseline was associated with a 5-fold increased risk to maintain a poor physical health after 6 months of active treatment with standard-dose MTX. Other less important determinants for maintenance of poor physical well being were the baseline level of systemic inflammation, the intensity of child's pain and an ANA-negative status. CONCLUSIONS: We report that MTX treatment produces a significant improvement across a wide range of HRQOL components, particularly in the physical domains, in patients with JIA.
URI: 
ISSN: 0003-4967
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Pediatric Immunology
× corresponding author
# (joint) last author

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