TY - JOUR T1 - Predictors of poor response to methotrexate in polyarticular-course juvenile idiopathic arthritis: analysis of the PRINTO methotrexate trial. JF - Ann Rheum Dis Y1 - 2010 A1 - Vilca, Iris A1 - Munitis, Pablo Garcia A1 - Pistorio, Angela A1 - Ravelli, Angelo A1 - Buoncompagni, Antonella A1 - Bica, Blanca A1 - Campos, Lucia A1 - Häfner, Renate A1 - Hofer, Michael A1 - Ozen, Seza A1 - Huemer, Christian A1 - Bae, Sang Cheol A1 - Sztajnbok, Flavio A1 - Arguedas, Olga A1 - Foeldvari, Ivan A1 - Huppertz, Hans Iko A1 - Gamir, María Luz A1 - Magnusson, Bo A1 - Dressler, Frank A1 - Uziel, Yosef A1 - van Rossum, Marion A J A1 - Hollingworth, Peter A1 - Cawkwell, Gail A1 - Martini, Alberto A1 - Ruperto, Nicolino KW - Adolescent KW - Antibodies, Antinuclear KW - Antirheumatic Agents KW - Arthritis, Juvenile KW - Child KW - Child, Preschool KW - Disability Evaluation KW - Female KW - Follow-Up Studies KW - Humans KW - Immunosuppressive Agents KW - Male KW - Methotrexate KW - Prognosis KW - Treatment Outcome AB -

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 < or = 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.

VL - 69 IS - 8 U1 - http://www.ncbi.nlm.nih.gov/pubmed/20525842?dopt=Abstract ER -