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Experience of the concentration of methotrexate evaluation in children with juvenile idiopathic arthritis

Pediatric Rheumatology20119 (Suppl 1) :P187

https://doi.org/10.1186/1546-0096-9-S1-P187

  • Published:

Keywords

  • Public Health
  • Arthritis
  • Methotrexate
  • Juvenile Idiopathic Arthritis
  • Rheumatic Disease

Juvenile idiopathic arthritis - one of the most common rheumatic disease in children (1:1000) [Timothy Beukelman et all, 2011]. The most effective basic drug is methotrexate, an initial dose of 15 mg/m2/week. Our study to determine the concentration of methotrexate in serum aims to develop a test system to clarify the reasons for lack of efficacy of methotrexate in some patients. The study currently includes 46 children (19 boys (41,3%), 27 girls (58.7%)) with different forms of JIA, according to the classification of ILAR. Systemic arthritis – 9 children (20%), arthritis oligoarticular – 9 (20%), polyarticular arthritis – 15 (34%), psoriatic arthritis – 1 (2%), arthritis entesitis – 11 (24%). Of the 46 children noone is in clinical remission off medication. 26 (56.5%) children met the criteria of inactive disease.

Results of determining the concentration of methotrexate in children with JIA were distributed as follows - 0-1 umol/l - 2,18%; 1-1,5 umol/l - 34.78%; 1,5-2 umol/l - 17.39 % 2-2,5 umol/l - 32.61%; 2,5-3 umol/l - 8.69% above 3 umol/l - 4,35%. Among children with the results of the concentration of methotrexate up to 1.5 umol/l - 88.24% have signs of active disease (elevated ESR / CRP high / dysproteinemia / active joints). Low concentrations of methotrexate in 73.3% are associated with high levels of ESR and CRP. Among children with the results of methotrexate concentration above 1,5 umol/l signs of active disease manifestations are much rarer in 48,28% of cases.

Authors’ Affiliations

(1)
The State Medical Pediatric Academy of Saint-Petersburg, Russia

Copyright

© Rokhlina et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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