PPW Lee, TL Lee, WHS Wong, YL Lau

Abstract

In the recent decade, an increasing number of disease-modifying anti-rheumatic drugs (DMARDs) have been developed for treatment in juvenile idiopathic arthritis (JIA). Currently, methotrexate (MTX) is the DMARD of first choice particularly in oligoarticular and polyarticular JIA, but its efficacy in systemic-onset JIA and enthesitis-related JIA was less satisfactory. A retrospective study on 40 patients followed up at Queen Mary Hospital for JIA was performed to review the treatment outcome and adverse effects associated with use of MTX. We concluded that MTX was safe and well tolerated in majority of patients, but treatment response varied with different JIA subtypes. Combination of MTX with other anti-inflammatory agents was often required to achieve disease remission in patients with more severe disease. Large, randomised controlled trials are needed to determine the efficacy of individual drug and their combination in each JIA subtype.