Combination therapy with methotrexate and cyclosporine A in juvenile idiopathic arthitis

Angelo Ravelli, Chiara Moretti, Francesca Temporini, Federica Rossi, Silvia Magni-Manzoni, Angela Pistorio, Alberto Martini

Research output: Contribution to journalArticle

Abstract

Objective. To investigate the efficacy and safety of a combination therapy with methotrexate (MTX) and cyclosporine A (CyA) in patients with juvenile idiopathic arthritis (JIA) who were refractory to MTX as a single second-line agent. Methods. Seventeen consecutive patients with JIA who had refractory polyarthritis despite a minimum of 6 months of MTX as a single second-line agent at the dose of 15 to 25 mg/m 2/week were continued with MTX with the addition of CyA (4 mg/kg/day) for 6 to 30 months (median 10 months) were analyzed. The clinical response to therapy was assessed through the preliminary definition of improvement in JIA. Results. At the end of the treatment, as compared to the time when CyA was added to MTX, 8 patients (47%) met the 30% definition of improvement; among them 5 (29%) met the 70% definition of improvement, and 2 (12%) achieved complete disease control. Seven patients (41%) experienced side effects: 4 gastrointestinal discomfort, 1 liver transaminase elevation, and 2 increase ≥ 30% in the serum creatinine concentration. No patients was discontinued from combination therapy due to adverse events. Conclusion. In our JIA patients who were refractory to MTX as a single second-line agent, the addition of CyA was associated with a significant clinical improvement in roughly half of the patients.

Original languageEnglish
Pages (from-to)569-572
Number of pages4
JournalClinical and Experimental Rheumatology
Volume20
Issue number4
Publication statusPublished - 2002

Keywords

  • Combination therapy
  • Cyclosporine
  • Juvenile chronic arthritis
  • Juvenile rheumatoid arthritis
  • Methotrexate

ASJC Scopus subject areas

  • Immunology
  • Rheumatology

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