PMID- 31699619
OWN - NLM
STAT- MEDLINE
DCOM- 20201125
LR  - 20210519
IS  - 2341-2879 (Electronic)
IS  - 2341-2879 (Linking)
VI  - 92
IP  - 3
DP  - 2020 Mar
TI  - [Methotrexate in juvenile idiopathic arthritis. Adverse effects and associated 
      factors].
PG  - 124-131
LID - S1695-4033(19)30201-2 [pii]
LID - 10.1016/j.anpedi.2019.05.010 [doi]
AB  - INTRODUCTION: Methotrexate (MTX) is the drug of choice for juvenile idiopathic 
      arthritis. Its clinical efficacy is limited due to the development of adverse 
      effects (AEs). PATIENTS AND METHODS: A retrospective observational study was 
      conducted on the AEs associated with MTX therapy in children diagnosed with 
      juvenile idiopathic arthritis followed-up in a tertiary hospital between 2008 and 
      2016. RESULTS: The study included a total of 107 patients, of whom 71 (66.3%) 
      were girls (66.3%). The median age at diagnosis was 6.4 years (IQR 3.1-12.4), 
      with a median follow-up of 45.7 months (IQR 28.8-92.4). There were 48 patients 
      (44.9%) with oligoarthritis, and 26 children (24.3%) with rheumatoid-factor 
      negative polyarthritis. Of these, 52/107 (48.6%) developed AEs, with the most 
      frequent being gastrointestinal symptoms (35.6%) and behavioural problems 
      (35.6%). An age older than 6 years at the beginning of therapy increased the risk 
      of developing AEs, both in the univariate (OR=3.5; 95% CI: 1.5-7.3) and 
      multivariate (12% increase per year) analyses. The doses used, administration 
      route, or International League of Associations for Rheumatology (ILAR) 
      classification, were not associated with the development of AEs. Twenty children 
      required a dosage or route of administration modification, which resolved the AE 
      in 11 (55%) cases. MTX was interrupted due to the development of AEs in 37/107 
      patients (34.6%), mainly due to increased plasma transaminases (n=14, 37.8%), 
      gastrointestinal symptoms (n=9, 24.3%) and behavioural problems (n=6, 16.3%). 
      CONCLUSIONS: MTX is the therapy of choice for patients with juvenile idiopathic 
      arthritis, but 50% of the children develop some form of AE. Although the AEs are 
      not severe, they lead to interruption of therapy in 35% of the children.
CI  - Copyright (c) 2019 Asociacion Espanola de Pediatria. Publicado por Elsevier Espana, 
      S.L.U. All rights reserved.
FAU - Barral Mena, Estefania
AU  - Barral Mena E
AD  - Servicio de Pediatria, Hospital Universitario Infanta Leonor, Madrid, Espana.
FAU - Garcia Cardaba, Luis Miguel
AU  - Garcia Cardaba LM
AD  - Unidad de Reumatologia Pediatrica, Hospital Universitario 12 de Octubre, Madrid, 
      Espana. Electronic address: luismi1229@gmail.com.
FAU - Canet Tarres, Anna
AU  - Canet Tarres A
AD  - Unidad de Reumatologia Pediatrica, Hospital Universitario 12 de Octubre, Madrid, 
      Espana.
FAU - Enriquez Merayo, Eugenia
AU  - Enriquez Merayo E
AD  - Servicio de Reumatologia, Clinica Universitaria de Navarra, Madrid, Espana.
FAU - Cruz Utrilla, Alejandro
AU  - Cruz Utrilla A
AD  - Servicio de Cardiologia, Hospital Clinico San Carlos, Madrid, Espana.
FAU - de Inocencio Arocena, Jaime
AU  - de Inocencio Arocena J
AD  - Unidad de Reumatologia Pediatrica, Hospital Universitario 12 de Octubre, Madrid, 
      Espana; Departamento de Salud Publica y Materno-Infantil, Facultad de Medicina, 
      Universidad Complutense de Madrid, Madrid, Madrid, Espana.
LA  - spa
PT  - Journal Article
PT  - Observational Study
TT  - Metotrexato en artritis idiopatica juvenil: efectos adversos y factores 
      asociados.
DEP - 20191104
PL  - Spain
TA  - An Pediatr (Engl Ed)
JT  - Anales de pediatria
JID - 101765626
RN  - 0 (Antirheumatic Agents)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Antirheumatic Agents/*adverse effects/therapeutic use
MH  - Arthritis, Juvenile/*drug therapy
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Male
MH  - Methotrexate/*adverse effects/therapeutic use
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Adverse effects
OT  - Artritis juvenil
OT  - Efectos adversos
OT  - Hipertransaminasemia
OT  - Intolerancia
OT  - Juvenile arthritis
OT  - Methotrexate
OT  - Metotrexato
OT  - Vomiting
EDAT- 2019/11/09 06:00
MHDA- 2020/11/26 06:00
CRDT- 2019/11/09 06:00
PHST- 2019/02/19 00:00 [received]
PHST- 2019/05/02 00:00 [revised]
PHST- 2019/05/21 00:00 [accepted]
PHST- 2019/11/09 06:00 [pubmed]
PHST- 2020/11/26 06:00 [medline]
PHST- 2019/11/09 06:00 [entrez]
AID - S1695-4033(19)30201-2 [pii]
AID - 10.1016/j.anpedi.2019.05.010 [doi]
PST - ppublish
SO  - An Pediatr (Engl Ed). 2020 Mar;92(3):124-131. doi: 10.1016/j.anpedi.2019.05.010. 
      Epub 2019 Nov 4.