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

被引：48

作者：

Vilca, Iris

Munitis, Pablo Garcia

Pistorio, Angela ^{[2
]}

Ravelli, Angelo ^{[3
]}

Buoncompagni, Antonella

Bica, Blanca ^{[4
]}

Campos, Lucia ^{[5
]}

Haefner, Renate ^{[6
]}

Hofer, Michael ^{[7
]}

Ozen, Seza ^{[8
]}

Huemer, Christian ^{[9
]}

Bae, Sang Cheol ^{[10
]}

Sztajnbok, Flavio ^{[11
]}

Arguedas, Olga

Foeldvari, Ivan ^{[12
]}

Huppertz, Hans Iko ^{[13
]}

Luz Gamir, Maria ^{[14
]}

Magnusson, Bo ^{[15
]}

Dressler, Frank ^{[16
]}

Uziel, Yosef ^{[17
]}

van Rossum, Marion A. J. ^{[18
,19
]}

Hollingworth, Peter ^{[20
]}

Cawkwell, Gail

Martini, Alberto ^{[3
]}

Ruperto, Nicolino ^{[1
]}

机构：

[1] Univ Genoa, IRCCS G Gaslini, PRINTO, I-16147 Genoa, Italy

[2] IRCCS G Gaslini, Serv Epidemiol & Biostat, Genoa, Italy

[3] Univ Genoa, Dipartimento Pediat, I-16147 Genoa, Italy

[4] Hosp Univ Clementino Fraga Filho UFRJ, Rio De Janeiro, Brazil

[5] Hosp Clin Sao Paulo, Inst Crianca, Sao Paulo, Brazil

[6] Deutsch Zentrum Kinder & Jugendrheumatol, Garmisch Partenkirchen, Germany

[7] Hop Univ HUG, CHUV, Ctr Multisite Romand Rhumatol Pediat, Lausanne, Switzerland

[8] Hacettepe Univ, Dept Pediat, Ankara, Turkey

[9] Landeskrankenhaus Bregenz, Bregenz, Austria

[10] Hanyang Univ, Hosp Rheumat Dis, Dept Rheumatol, Seoul 133791, South Korea

[11] Hosp Univ Pedro Ernesto, Nucleo Estudos Saude Adolescente, Rio De Janeiro, Brazil

[12] Hamburger Zentrum Kinder & Jugendrheumatol, Hamburg, Germany

[13] Prof Hess Kinderklin, Bremen, Germany

[14] Hosp Ramon & Cajal, E-28034 Madrid, Spain

[15] Karolinska Univ Hosp, Stockholm, Sweden

[16] Hannover Med Sch, D-30623 Hannover, Germany

[17] Haemek Hosp, Afula, Israel

[18] Emma Childrens Hosp AMC, Amsterdam, Netherlands

[19] Jan van Breemen Inst, Dept Rheumatol, Amsterdam, Netherlands

[20] N Bristol NHS Trust, Bristol, Avon, England

来源：

ANNALS OF THE RHEUMATIC DISEASES | 2010年 / 69卷 / 08期

关键词：

QUALITY-OF-LIFE; ITALIAN INCEPTION COHORTS; PLACEBO-CONTROLLED TRIAL; TERM HEALTH OUTCOMES; RHEUMATOID-ARTHRITIS; DOUBLE-BLIND; CHILDREN; DISEASE; PROGRESSION; DISABILITY;

D O I：

10.1136/ard.2009.120840

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 wellbeing <= 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.

引用

页码：1479 / 1483

页数：5

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