Predictors of poor response to methotrexate in polyarticular-course juvenile idiopathic arthritis: Analysis of the PRINTO methotrexate trial

Iris Vilca, Pablo Garcia Munitis, Angela Pistorio, Angelo Ravelli, Antonella Buoncompagni, Blanca Bica, Lucia Campos, Renate Häfner, Michael Hofer, Seza Ozen, Christian Huemer, Sang Cheol Bae, Flavio Sztajnbok, Olga Arguedas, Ivan Foeldvari, Hans Iko Huppertz, Maria Luz Gamir, Bo Magnusson, Frank Dressler, Yosef UzielMarion A J Van Rossum, Peter Hollingworth, Gail Cawkwell, Alberto Martini, Nicolino Ruperto

Research output: Contribution to journalArticle

Abstract

Objectives: To determine whether baseline demographic, clinical, articular and laboratory variables predict methotrexate (MTX) poor response in polyarticular-course juvenile idiopathic arthritis. Methods: Patients newly treated for 6 months with MTX enrolled in the Paediatric Rheumatology International Trials Organization (PRINTO) MTX trial. Bivariate and logistic regression analyses were used to identify baseline predictors of poor response according to the American College of Rheumatology pediatric (ACR-ped) 30 and 70 criteria. Results: In all, 405/563 (71.9%) of patients were women; median age at onset and disease duration were 4.3 and 1.4 years, respectively, with anti-nuclear antibody (ANA) detected in 259/537 (48.2%) patients. With multivariate logistic regression analysis, the most important determinants of ACR-ped 70 non-responders were: disease duration >1.3 years (OR 1.93), ANA negativity (OR 1.77), Childhood Health Assessment Questionnaire (CHAQ) disability index>1.125 (OR 1.65) and the presence of right and left wrist activity (OR 1.55). Predictors of ACR-ped 30 non-responders were: ANA negativity (OR 1.92), CHAQ disability index>1.14 (OR 2.18) and a parent's evaluation of child's overall well-being ≤4.69 (OR 2.2). Conclusion: The subgroup of patients with longer disease duration, ANA negativity, higher disability and presence of wrist activity were significantly associated with a poorer response to a 6-month MTX course.

Original languageEnglish
Pages (from-to)1479-1483
Number of pages5
JournalAnnals of the Rheumatic Diseases
Volume69
Issue number8
DOIs
Publication statusPublished - Aug 2010

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Allergy

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    Vilca, I., Munitis, P. G., Pistorio, A., Ravelli, A., Buoncompagni, A., Bica, B., Campos, L., Häfner, R., Hofer, M., Ozen, S., Huemer, C., Bae, S. C., Sztajnbok, F., Arguedas, O., Foeldvari, I., Huppertz, H. I., Gamir, M. L., Magnusson, B., Dressler, F., ... Ruperto, N. (2010). Predictors of poor response to methotrexate in polyarticular-course juvenile idiopathic arthritis: Analysis of the PRINTO methotrexate trial. Annals of the Rheumatic Diseases, 69(8), 1479-1483. https://doi.org/10.1136/ard.2009.120840